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Angela lorts

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https://www.readbyqxmd.com/read/29752919/first-use-of-heartmate-3-tm-in-a-failing-fontan-circulation
#1
Angela Lorts, Chet Villa, Kyle W Riggs, John Broderick, David Ls Morales
The failing Fontan circulation can be challenging to support with ventricular assist devices (VAD) mostly due to the variety of causes of failure, some of which cannot be addressed by VAD therapy alone. A new VAD, the HeartMate 3TM , was recently approved for use in adults in the United States and is now widely available with excellent survival in two-ventricle patients. We report the first successful implantation of the HeartMate 3 in a 22-year-old male with a failing Fontan circulation and the possible benefits it may have in supporting this ever-growing population of young adults with single ventricles...
May 9, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29723531/transplant-outcomes-for-congenital-heart-disease-patients-bridged-with-a-ventricular-assist-device
#2
Roosevelt Bryant, Raheel Rizwan, Chet R Villa, Farhan Zafar, Dennis Wells, Clifford Chin, Angela Lorts, David L Morales
BACKGROUND: Ventricular assist device (VAD) use as a bridge-to-transplant (BTT) for children with end-stage heart failure and congenital heart disease (CHD), although challenging, has increased but its impact on post-transplant outcome is unknown. This study describes post-transplant outcomes of CHD patients BTT with a VAD. METHODS: All heart transplants identified in UNOS database from 2006-2015 (N=21,865) were divided into four groups based on the diagnosis of CHD and VAD support at transplant: +CHD/+VAD, +CHD/-VAD, +VAD/-CHD and -VAD/-CHD...
April 30, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29673634/the-right-tool-for-the-right-job-bridging-a-failing-fontan-to-transplant
#3
Kyle W Riggs, Angela Lorts, Chet R Villa, James Tweddell, Roosevelt Bryant, David Ls Morales
Mechanical circulatory support and heart transplantation are both becoming increasingly common in Fontan patients as this growing cohort of patients is reaching young adulthood. Though device placement may present challenges, the new focus is on selecting the correct cannulation sites and devices at the correct time in order to successfully bridge these challenging patients to heart transplant. Herein, we report the use of multiple mechanical circulatory support strategies tailored to the clinical setting which culminated in 130 days of support prior to cardiac transplantation in a young adult with a failing Fontan circulation...
April 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29561310/mechanical-circulatory-support-challenges-in-pediatric-and-adult-congenital-heart-disease
#4
Martin Schweiger, Angela Lorts, Jennifer Conway
PURPOSE OF REVIEW: Increased miniaturization of ventricular assist devices (VADs) and new mechanical support strategies (MCS) has increased the use of MCS in the pediatric and congenital heart disease (CHD) population. This comes with the need for care providers specialized in this field to determine optimal patient and device selection, and to improve outcomes and decrease complication rates for new innovative strategies. A review of the published literature in this field is timely and relevant...
March 20, 2018: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29380475/is-there-an-optimal-organ-acceptance-rate-for-pediatric-heart-transplantation-a-sweet-spot
#5
Chun Soo Park, Chet R Villa, Angela Lorts, Clifford Chin, James S Tweddell, Farhan Zafar, David L S Morales
Despite a limited supply of donors, potential donor hearts are often declined for subjective concerns regarding organ quality. This analysis will investigate the relationship between donor heart AR and patient outcome at pediatric transplant centers. The UNOS database was used to identify all match runs for pediatric candidates (age < 18 years) from 2008 through March 2015 in which a heart offer was ultimately placed. Centers which received ≥10 offers/y were included (10 634 offers, 38 centers). Transplant centers were stratified based on their AR: low (<20%, n = 13), medium (20%-40%, n = 16), or high (>40%, n = 9)...
May 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29258675/the-number-of-refusals-for-donor-organ-quality-does-not-impact-heart-transplant-outcomes-in-children
#6
Raheel Rizwan, Farhan Zafar, Roosevelt Bryant, James S Tweddell, Angela Lorts, Clifford Chin, David L Morales
BACKGROUND: Waitlist mortality is more than 12% for pediatric heart transplantation, with strikingly high rates of organ refusal, many of which are due to donor quality. However, some centers use these organs despite refusals by other centers for donor quality. We hypothesize that the number of refusals for donor quality (RDQ) does not affect pediatric heart transplantation outcomes. METHODS: Pediatric heart transplants from 2000 to 2015 were identified using the United Network for Organ Sharing database and were matched against the potential transplant recipients dataset with donor refusal codes...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29212898/genetic-testing-in-pediatric-left-ventricular-noncompaction
#7
Erin M Miller, Robert B Hinton, Richard Czosek, Angela Lorts, Ashley Parrott, Amy R Shikany, Richard F Ittenbach, Stephanie M Ware
BACKGROUND: Left ventricular noncompaction (LVNC) can occur in isolation or can co-occur with a cardiomyopathy phenotype or cardiovascular malformation. The yield of cardiomyopathy gene panel testing in infants, children, and adolescents with a diagnosis of LVNC is unknown. By characterizing a pediatric population with LVNC, we sought to determine the yield of cardiomyopathy gene panel testing, distinguish the yield of testing for LVNC with or without co-occurring cardiac findings, and define additional factors influencing genetic testing yield...
December 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/29174220/outcomes-of-children-supported-with-devices-labeled-as-temporary-or-short-term-a-report-from-the-pediatric-interagency-registry-for-mechanical-circulatory-support
#8
Angela Lorts, Pirooz Eghtesady, Mary Mehegan, Iki Adachi, Chet Villa, Ryan Davies, Jeffrey G Gossett, Kirk Kanter, Juan Alejos, Devin Koehl, Ryan S Cantor, David L S Morales
BACKGROUND: Historically, the "temporary" or short-term ventricular assist device (VAD) was used only as a quick bridge to recovery for children with an acute process. In the current era, the devices that were originally used for temporary support are now being used to support children for longer durations and for a variety of indications. In this study we aimed to describe the overall use, patients' characteristics and outcomes of "temporary" VAD use in children. METHODS: The Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) is a National Institutes of Health-supported national registry for United States Food and Drug Administration-approved VADs in patients <19 years of age at the time of VAD implantation (either durable or temporary VAD)...
January 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28991810/inferior-transplant-outcomes-of-adolescents-and-young-adults-bridged-with-ventricular-assist-device
#9
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
#10
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...
January 2018: 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28259596/berlin-heart-excor-use-in-patients-with-congenital-heart-disease
#17
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
#18
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
#19
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
#20
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
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