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Angela lorts

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https://www.readbyqxmd.com/read/27816511/does-small-size-matter-with-continuous%C3%A2-flow-devices-analysis-of-the-intermacs-database-of-adults-with-bsa%C3%A2-%C3%A2-1-5-m-2
#1
Farhan Zafar, Chet R Villa, David L Morales, Elizabeth D Blume, David N Rosenthal, James K Kirklin, Angela Lorts
OBJECTIVES: This study investigated how small patient size affects clinical outcomes in patients implanted with a continuous flow left ventricular assist device (CFLVAD). BACKGROUND: The development of smaller CFLVADs has allowed ventricular assist device (VAD) use in anatomically smaller patients; however, limited outcome data exist regarding CFLVAD use in patients with a body surface area (BSA) ≤1.5 m(2). METHODS: All CFLVAD patients entered in the Interagency Registry for Mechanically Assisted Circulatory Support registry April 2008 to September 2013 and with BSA data were included...
October 27, 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27660899/transplant-survival-following-berlin-heart-excor%C3%A2-support
#2
Roosevelt Bryant, Farhan Zafar, Chesney Castleberry, John L Jefferies, Angela Lorts, Clifford Chin, David L S Morales
The Berlin Heart EXCOR pediatric ventricular assist device is approved by the FDA for bridge to cardiac transplantation (BTT) in children. As the clinical outcomes of the EXCOR continue to be evaluated in the U.S., data on post transplant survival are needed. The UNOS database was used to identify patients < 18 years old undergoing orthotopic heart transplantation (OHT) from 6/2004 to 6/2014. Patients undergoing BTT with the EXCOR were identified. A matched cohort of (358) patients undergoing OHT without pre-transplant mechanical circulatory support (no-MCS) was also identified as controls...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27585126/sudden-cardiac-arrest-in-pediatrics
#3
RoseAnn L Scheller, Laurie Johnson, Angela Lorts, Thomas D Ryan
Sudden cardiac arrest (SCA) in the pediatric population is a rare and potentially devastating occurrence. An understanding of the differential diagnosis for the etiology of the cardiac arrest allows for the most effective emergency care and provides the patient with the best possible outcome. Pediatric SCA can occur with or without prodromal symptoms and may occur during exercise or rest. The most common cause is arrhythmia secondary to an underlying channelopathy, cardiomyopathy, or myocarditis. After stabilization, evaluation should include electrocardiogram, chest radiograph, and echocardiogram...
September 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27490595/ventricular-assist-devices-in-pediatric-cardiac-intensive-care
#4
Jonathan Byrnes, Chet Villa, Angela Lorts
OBJECTIVES: The objectives of this review are to discuss the process of patient and mechanical device selection, operative management, and postoperative care with a focus on the management of right ventricular failure, anticoagulation strategies, device-related infections and neurologic sequelae. DATA SOURCES: MEDLINE, PubMed. CONCLUSION: The number of patients with advanced heart failure due to either acquired or congenital heart disease continues to increase, necessitating in some mechanical circulatory support and in others cardiac transplantation...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27477950/obtaining-consensus-regarding-international-transplantation-continues-to-be-difficult-for-pediatric-centers-in-the-united-states
#5
REVIEW
Angela Lorts, Thomas D Ryan, Armand H Matheny Antommaria, Michael Lake, John Bucuvalas
Organ transplant is life-saving and any given organ may be valuable to a multitude of potential recipients. An allocation system must be used to reconcile the difference between supply and demand, and this system must take into account the impact that accepting international patients may have on the local system. The principles for allocation must be clear, equitable, provide utility and must be monitored so as to maintain public trust. The impact of the system on metrics deemed to be critical must be measured...
September 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27453068/cardiac-destination-therapy-in-pediatrics-are-we-there-yet
#6
EDITORIAL
Chet R Villa, Angela Lorts
No abstract text is available yet for this article.
September 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27357002/the-impact-of-concomitant-left-ventricular-non-compaction-with-congenital-heart-disease-on-perioperative-outcomes
#7
Preeti Ramachandran, Jessica G Woo, Thomas D Ryan, Roosevelt Bryant, Haleh C Heydarian, John L Jefferies, Jeffrey A Towbin, Angela Lorts
Left ventricular non-compaction (LVNC) is a heterogeneous myocardial disorder characterized by prominent trabeculations and inter-trabecular recesses which may occur in association with congenital heart disease (CHD). To date, few studies have been performed to assess whether the concomitant diagnosis of LVNC affects the outcomes of CHD surgery. A retrospective review of patients with LVNC with CHD (LVNC-CHD), 0-5 years of age, was conducted. Patients with CHD without LVNC (CHD-only) and 0-5 years of age with similar diagnosis distribution were selected for comparison...
October 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27102953/allosensitization-does-not-alter-post-transplant-outcomes-in-pediatric-patients-bridged-to-transplant-with-a-ventricular-assist-device
#8
Chesney Castleberry, Farhan Zafar, Tamara Thomas, Muhammad S Khan, Roosevelt Bryant, Clifford Chin, David L S Morales, Angela Lorts
Patients supported with a VAD are at increased risk for sensitization. We aimed to determine risk factors for sensitization as well as the impact of sensitization on post-transplant outcomes. The UNOS database (January 2004-June 2014) was used to identify patients (≤18 yrs) supported with a durable VAD. Rates and degree of sensitization in the VAD cohort were calculated. Post-transplant survival was determined comparing outcomes of sensitized vs. non-sensitized patients. There were 3097 patients included in the study; 19% (n = 579) were bridged with a VAD...
June 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27056612/outcomes-of-pediatric-patients-supported-with-continuous-flow-ventricular-assist-devices-a-report-from-the-pediatric-interagency-registry-for-mechanical-circulatory-support-pedimacs
#9
Joseph W Rossano, Angela Lorts, Christina J VanderPluym, Aamir Jeewa, Kristine J Guleserian, Mark S Bleiweis, Olaf Reinhartz, Elizabeth D Blume, David N Rosenthal, David C Naftel, Ryan S Cantor, James K Kirklin
BACKGROUND: Continuous-flow (CF) ventricular assist devices (VADs) have largely replaced pulsatile-flow VADs in adult patients. However, there are few data on CF VADs among pediatric patients. In this study we aimed to describe the overall use, patients' characteristics and outcomes of CF VADs in this population. METHODS: The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a national registry for U.S. Food and Drug Adminstration (FDA)-approved VADs in patients <19 years of age...
May 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27009673/outcomes-of-children-implanted-with-ventricular-assist-devices-in-the-united-states-first-analysis-of-the-pediatric-interagency-registry-for-mechanical-circulatory-support-pedimacs
#10
Elizabeth D Blume, David N Rosenthal, Joseph W Rossano, J Timothy Baldwin, Pirooz Eghtesady, David L S Morales, Ryan S Cantor, Jennifer Conway, Angela Lorts, Christopher S Almond, David C Naftel, James K Kirklin
BACKGROUND: Use of mechanical circulatory support in children has increased as more options have become available. A national account of the use of mechanical support in children and adolescents is essential to understanding outcomes, refining patient selection and improving quality of care. METHODS: The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a National Heart, Lung, and Blood Institute-supported nationwide registry for temporary and durable ventricular assist device (VAD) use in patients <19 years of age...
May 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/26841274/now-how-do-we-get-them-home-outpatient-care-of-pediatric-patients-on-mechanical-circulatory-support
#11
REVIEW
Jennifer Conway, Christina VanderPluym, Aamir Jeewa, Selvi Sinnadurai, Amanda Schubert, Angela Lorts
The last five yr have been monumental for the pediatric heart failure community. In the US, the most notable has been the FDA approval of the first pediatric specific device (Berlin Heart EXCOR(®) ; Berlin Heart, Inc., Berlin, Germany). Subsequently, the field of heart failure has gained a great deal of knowledge regarding the nuances of MCS in children. Despite FDA approval in the US, the Berlin EXCOR(®) is only currently indicated for in-hospital use. Due to the limitations with discharge and the positive in- hospital experiences with the Berlin EXCOR(®) , there has been an increased interest in the implantation of adult durable devices into children...
March 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/26714996/clinical-issues-and-controversies-in-heart-failure-and-transplantation
#12
REVIEW
Joseph W Rossano, Timothy M Hoffman, John L Jefferies, Angela Lorts, Roxanne E Kirsch, Ravi R Thiagarajan
Heart failure is a common problem among children admitted in the intensive care unit and is associated with significant morbidity and mortality. As such, the 2014 meeting of the Pediatric Cardiac Intensive Care Society included a session on Clinical Controversies in Heart Failure and Transplantation. This review contains the summaries of the podium presentations of this session and will cover some of the challenging aspects of caring for these patients including medical and mechanical support, fluid overload states, high-risk populations including those after heart transplantation, and end-of-life considerations...
January 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/26687150/initial-observations-of-the-effects-of-calcium-chloride-infusions-in-pediatric-patients-with-low-cardiac-output
#13
Konstantin Averin, Chet Villa, Catherine D Krawczeski, Jesse Pratt, Eileen King, John L Jefferies, David P Nelson, David S Cooper, Thomas D Ryan, Jaclyn Sawyer, Jeffrey A Towbin, Angela Lorts
Myocardial contractility and relaxation are highly dependent on calcium homeostasis. Immature myocardium, as in pediatric patients, is thought to be more dependent on extracellular calcium for optimal function. For this reason, intravenous calcium chloride infusions may improve myocardial function in the pediatric patient. The objectives of this study were to report the hemodynamic changes seen after administration of continuous calcium chloride to critically ill children. We retrospectively identified pediatric patients (newborn to 17 years old) with hemodynamic instability admitted to the cardiac ICU between May 2011 and May 2012 who received a continuous infusion of calcium chloride...
March 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/26564821/deletion-of-periostin-protects-against-atherosclerosis-in-mice-by-altering-inflammation-and-extracellular-matrix-remodeling
#14
Jennifer A Schwanekamp, Angela Lorts, Ronald J Vagnozzi, Davy Vanhoutte, Jeffery D Molkentin
OBJECTIVE: Periostin is a secreted protein that can alter extracellular matrix remodeling in response to tissue injury. However, the functional role of periostin in the development of atherosclerotic plaques has yet to be described despite its observed induction in diseased vessels and presence in the serum. APPROACH AND RESULTS: Hyperlipidemic, apolipoprotein E-null mice (ApoE(-/) (-)) were crossed with periostin (Postn(-/-)) gene-deleted mice and placed on a high-fat diet for 6 or 14 weeks to induce atherosclerosis...
January 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/26262463/pediatric-mechanical-circulatory-support-available-devices-and-outcomes-as-bridge-to-transplant-therapy
#15
REVIEW
Angela Lorts, Elizabeth D Blume
PURPOSE OF REVIEW: The use of mechanical circulatory support in children has increased dramatically over the current decade. A review of the pediatric ventricular assist device (VAD) literature is timely and relevant in order to improve outcomes and refine patient selection as new devices become available and current VADs are used in smaller patients. RECENT FINDINGS: Outcomes of pediatric patients bridged to transplant with VAD therapy continue to improve. Patient selection in children continues to be complex as size and anatomy make decision-making unique from the adult practice...
October 2015: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/26039989/large-scale-serum-protein-biomarker-discovery-in-duchenne-muscular-dystrophy
#16
Yetrib Hathout, Edward Brody, Paula R Clemens, Linda Cripe, Robert Kirk DeLisle, Pat Furlong, Heather Gordish-Dressman, Lauren Hache, Erik Henricson, Eric P Hoffman, Yvonne Monique Kobayashi, Angela Lorts, Jean K Mah, Craig McDonald, Bob Mehler, Sally Nelson, Malti Nikrad, Britta Singer, Fintan Steele, David Sterling, H Lee Sweeney, Steve Williams, Larry Gold
Serum biomarkers in Duchenne muscular dystrophy (DMD) may provide deeper insights into disease pathogenesis, suggest new therapeutic approaches, serve as acute read-outs of drug effects, and be useful as surrogate outcome measures to predict later clinical benefit. In this study a large-scale biomarker discovery was performed on serum samples from patients with DMD and age-matched healthy volunteers using a modified aptamer-based proteomics technology. Levels of 1,125 proteins were quantified in serum samples from two independent DMD cohorts: cohort 1 (The Parent Project Muscular Dystrophy-Cincinnati Children's Hospital Medical Center), 42 patients with DMD and 28 age-matched normal volunteers; and cohort 2 (The Cooperative International Neuromuscular Research Group, Duchenne Natural History Study), 51 patients with DMD and 17 age-matched normal volunteers...
June 9, 2015: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/25865865/left-ventricular-non-compaction-cardiomyopathy
#17
REVIEW
Jeffrey A Towbin, Angela Lorts, John Lynn Jefferies
Left ventricular non-compaction, the most recently classified form of cardiomyopathy, is characterised by abnormal trabeculations in the left ventricle, most frequently at the apex. It can be associated with left ventricular dilation or hypertrophy, systolic or diastolic dysfunction, or both, or various forms of congenital heart disease. Affected individuals are at risk of left or right ventricular failure, or both. Heart failure symptoms can be induced by exercise or be persistent at rest, but many patients are asymptomatic...
August 22, 2015: Lancet
https://www.readbyqxmd.com/read/25557132/difficult-decision-what-should-we-do-when-a-vad-supported-child-experiences-a-severe-stroke
#18
Stefanie Benoit, Armand H Matheny Antommaria, Norbert Weidner, Angela Lorts
No abstract text is available yet for this article.
March 2015: Pediatric Transplantation
https://www.readbyqxmd.com/read/25447574/pediatric-heart-transplant-waiting-list-mortality-in-the-era-of-ventricular-assist-devices
#19
Farhan Zafar, Chesney Castleberry, Muhammad S Khan, Vivek Mehta, Roosevelt Bryant, Angela Lorts, Ivan Wilmot, John L Jefferies, Clifford Chin, David L S Morales
BACKGROUND: Earlier reviews have reported unacceptably high incidence of pediatric heart transplant (PHT) waiting list mortality. An increase in ventricular assist devices (VAD) suggests a potential positive effect. This study evaluated PHT waiting list mortality in the era of pediatric VADs. METHODS: United Network of Organ Sharing (UNOS) database from 1999 to 2012 showed 5,532 pediatric candidates (aged ≤ 18 years) actively listed for PHT: 2,191 were listed in 1999 to 2004 (Era 1) and 3,341 were listed in 2005 to 2012 (Era 2)...
January 2015: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/25440410/the-use-of-a-berlin-heart-excor-lvad-in-a-child-receiving-chemotherapy-for-castleman-s-disease
#20
Tamara O Thomas, Shanmuganathan Chandrakasan, Maureen O'Brien, John L Jefferies, Thomas D Ryan, Ivan Wilmot, Michael L Baker, Peace C Madueme, David Morales, Angela Lorts
We present the unique case of a pediatric patient who received chemotherapy for a diagnosis of CD, while mechanically supported with a Berlin EXCOR LVAD secondary to restrictive cardiomyopathy. A four-yr-old previously healthy male with restrictive cardiomyopathy required MCS after cardiac arrest but was diagnosed with multicentric CD, a non-malignant lymphoproliferative disorder fueled by excessive IL-6 production. Treatment with IL-6 blockade (tocilizumab) every two wk and methylprednisolone had no effect on his lymph nodes or cardiac function while on temporary RotaFlow...
February 2015: Pediatric Transplantation
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