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Angela lorts

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https://www.readbyqxmd.com/read/28991810/inferior-transplant-outcomes-of-adolescents-and-young-adults-bridged-with-ventricular-assist-device
#1
Raheel Rizwan, Roosevelt Bryant, Farhan Zafar, Chet R Villa, Angela Lorts, David L Morales
Adolescents, who are thought to have compliance issues, are well known to have poor heart transplant (HTx) outcomes. This "effect" has recently been demonstrated to extend to age 29. The study sought to investigate whether the poor outcomes for HTx related to adolescent age are also observed in recipients who are bridged to transplant (BTT) with a ventricular assist device (VAD) and whether this effect extends beyond the standard definition of adolescent age 12-18 years. All HTx BTT with a VAD in recipients 8-39 years were identified in the United States Organ Sharing (UNOS) database (1 January 2005 to 30 June 2016)...
October 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28965736/second-annual-pediatric-interagency-registry-for-mechanical-circulatory-support-pedimacs-report-pre-implant-characteristics-and-outcomes
#2
Elizabeth D Blume, Christina VanderPluym, Angela Lorts, J Timothy Baldwin, Joseph W Rossano, David L S Morales, Ryan S Cantor, Marissa A Miller, James D St Louis, Devin Koehl, David L Sutcliffe, Pirooz Eghtesady, James K Kirklin, David N Rosenthal
BACKGROUND: Expanded use of pediatric ventricular assist devices (VADs) has decreased mortality in children awaiting heart transplantation. Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs), a National Heart, Lung, and Blood Institute-sponsored North American database, provides a platform to understand this emerging population. METHODS: Between September 2012 and September 2016, patients aged younger than 19 years who underwent VAD implantation were enrolled in Pedimacs...
July 4, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28836710/airway-plaque-presenting-after-alteration-of-immunosuppression-in-a-pediatric-patient-remote-from-heart-transplantation
#3
Thomas D Ryan, Michael J Absalon, Alessandro de Alarcon, Anita Gupta, Anna L Peters, Angela Lorts, Lara A Danziger-Isakov, Clifford Chin
Success after solid organ transplantation is dependent on the proper balance of immunosuppression to prevent rejection of the allograft while limiting the risk of developing infections and malignancy. We present a 9-year-old girl, remote from transplant, who presented with airway plaque after a change in immunosuppression to include the mTOR inhibitor sirolimus. Differential diagnosis included direct medication side effect, infection, and neoplasia.
November 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28781010/an-ishlt-consensus-document-for-prevention-and-management-strategies-for-mechanical-circulatory-support-infection
#4
EDITORIAL
Shimon Kusne, Martha Mooney, Lara Danziger-Isakov, Annemarie Kaan, Lars H Lund, Haifa Lyster, Georg Wieselthaler, Saima Aslam, Barbara Cagliostro, Jonathan Chen, Pamela Combs, Adam Cochrane, Jennifer Conway, Jennifer Cowger, Maria Frigerio, Rochelle Gellatly, Paolo Grossi, Finn Gustafsson, Margaret Hannan, Angela Lorts, Stanley Martin, Sean Pinney, Fernanda P Silveira, Stephan Schubert, Stephan Schueler, Martin Strueber, Nir Uriel, Neil Wrightson, Rachel Zabner, Shirish Huprikar
No abstract text is available yet for this article.
October 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28750100/tgfbi-functions-similar-to-periostin-but-is-uniquely-dispensable-during-cardiac-injury
#5
Jennifer A Schwanekamp, Angela Lorts, Michelle A Sargent, Allen J York, Kelly M Grimes, Demetria M Fischesser, Jason J Gokey, Jeffrey A Whitsett, Simon J Conway, Jeffery D Molkentin
Extracellular matrix production and accumulation stabilize the heart under normal conditions as well as form a protective scar after myocardial infarction injury, although excessive extracellular matrix accumulation with long-standing heart disease is pathological. In the current study we investigate the role of the matricellular protein, transforming growth factor beta-induced (TGFBI), which is induced in various forms of heart disease. Additionally, we sought to understand whether TGFBI is functionally redundant to its closely related family member periostin, which is also induced in the diseased heart...
2017: PloS One
https://www.readbyqxmd.com/read/28606399/pediatric-continuous-flow-left-ventricular-assist-devices-no-longer-just-a-bridge-the-changing-of-a-mindset
#6
EDITORIAL
Chet R Villa, Angela Lorts, David L S Morales
No abstract text is available yet for this article.
May 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28366553/implications-and-outcomes-of-cardiac-grafts-refused-by-pediatric-centers-but-transplanted-by-adult-centers
#7
Farhan Zafar, Raheel Rizwan, Angela Lorts, Roosevelt Bryant, James S Tweddell, Clifford Chin, David L Morales
BACKGROUND: According to Organ Procurement Transplant Network policy, hearts from donors age <18 years are offered to pediatric recipients before being offered to adults of the same health status. We aimed to analyze differences in the use of adolescent donor hearts between adult and pediatric candidates and also to analyze the outcomes of pediatric candidates in which an adolescent donor heart was refused and later used in an adult recipient. METHODS: All adolescent donors (age 12-17 years) for 2000 to 2015 were identified using the standard United Network of Organ Sharing dataset and matched against the Potential Transplant Recipient dataset...
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28365178/pediatric-heart-donor-assessment-tool-ph-dat-a-novel-donor-risk-scoring-system-to-predict-1-year-mortality-in-pediatric-heart-transplantation
#8
Farhan Zafar, Robert D Jaquiss, Christopher S Almond, Angela Lorts, Clifford Chin, Raheel Rizwan, Roosevelt Bryant, James S Tweddell, David L S Morales
BACKGROUND: In this study we sought to quantify hazards associated with various donor factors into a cumulative risk scoring system (the Pediatric Heart Donor Assessment Tool, or PH-DAT) to predict 1-year mortality after pediatric heart transplantation (PHT). METHODS: PHT data with complete donor information (5,732) were randomly divided into a derivation cohort and a validation cohort (3:1). From the derivation cohort, donor-specific variables associated with 1-year mortality (exploratory p-value < 0...
March 7, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28259596/berlin-heart-excor-use-in-patients-with-congenital-heart-disease
#9
David L S Morales, Farhan Zafar, Christopher S Almond, Charles Canter, Francis Fynn-Thompson, Jennifer Conway, Iki Adachi, Angela Lorts
BACKGROUND: Management of mechanical circulatory support in children with congenital heart disease (CHD) is challenging due to physiologic variations and anatomic limitations to device placement. In this study we examine the use of Berlin Heart EXCOR in CHD patients. METHODS: CHD patients were identified from the EXCOR Pediatric Study data set (2007 to 2010). Mortality and serious adverse events were compared between CHD and non-CHD cohorts, and predictors of poor outcomes in the CHD cohort were identified...
November 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28146440/sudden-collapse-of-a-preschool-aged-child-on-the-playground
#10
RoseAnn L Scheller, Laurie H Johnson, Michelle C Caruso, Angela Lorts
PURPOSE: Primary cardiac events are rare in children. There is little information in the literature regarding the most appropriate emergency department (ED) management of this type of pediatric patient, especially with regard to medication use. SUMMARY: This case highlights the pediatric ED evaluation and treatment of sudden collapse in a child with an ultimate diagnosis of hypertrophic cardiomyopathy. Cardiac disorders represent 2% to 6% of cases of pediatric syncope presenting to EDs, particularly if there are previous prodromal symptoms and/or a history of exertion...
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28125462/united-states-trends-in-pediatric-ventricular-assist-implantation-as-bridge-to-transplantation
#11
Chet R Villa, Muhammad S Khan, Farhan Zafar, David L S Morales, Angela Lorts
Ventricular assist devices (VADs) are increasingly used to support children to heart transplant, however, it is unclear whether this trend is broadly applicable across the age/size spectrum. Children (≤18 years) listed for transplant were identified from the United Network of Organ Sharing (UNOS) database between January 2006 and May 2014. Patients were stratified by era (Early: 2006-2010, Current: 2011-2014), size (<25, 25-50, and >50 kg), and device type. Of 3,986 patients, 520 (13%) were supported by a VAD...
July 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28101662/strategies-to-prevent-cast-formation-in-patients-with-plastic-bronchitis-undergoing-heart-transplantation
#12
John J Parent, Robert K Darragh, Jeffrey G Gossett, Thomas D Ryan, Chet R Villa, Angela Lorts, John L Jefferies, Jeffrey A Towbin, Clifford Chin
Plastic bronchitis, a rare complication after Fontan palliation, carries a high morbidity and mortality risk. Heart transplantation is an effective treatment option, but casts may occur in the early post-operative period. We present a case series detailing peri-operative management strategies to minimize morbidity and mortality related to plastic bronchitis in patients undergoing heart transplantation. Patient 1 received no treatment pre-, intra-, or post-transplant for prevention of bronchial casts and developed severe respiratory acidosis 18 h following transplant...
June 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28009714/worldwide-experience-with-the-syncardia-total-artificial-heart-in-the-pediatric-population
#13
David L S Morales, Angela Lorts, Raheel Rizwan, Farhan Zafar, Francisco A Arabia, Chet R Villa
Individual centers have documented the use of the Syncardia Total Artificial Heart (TAH) in adolescents with heart failure; however, the number of patients at any given center is small. Herein, we describe the worldwide experience for all patients ≤21 years old supported with the TAH between May 2005 and May 2015 (n = 43). The number of patients experiencing a positive outcome at 60, 90, and 120 days were 30 (70%), 27 (63%), and 25 (58%), respectively. Successful bridge to transplantation varied by diagnosis, but outcomes reported are similar to adults supported with the TAH or biventricular assist devices...
July 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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
#14
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-after-berlin-heart-excor-support
#15
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 (VAD) is approved by the Food and Drug Administration for bridge to cardiac transplantation (BTT) in children. As the clinical outcomes of the EXCOR continue to be evaluated in the United States, data on post-transplant survival are needed. The UNOS database was used to identify patients <18 years old undergoing orthotopic heart transplantation (OHT) from June 2004 to June 2014. Patients undergoing BTT with the EXCOR were identified. A matched cohort of (358) patients undergoing OHT without pretransplant mechanical circulatory support (no-MCS) was also identified as control subjects...
January 2017: 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
#16
REVIEW
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
#17
REVIEW
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
#18
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
#19
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
#20
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
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