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Kirk Kanter

Meena Nathan, Marshall L Jacobs, J William Gaynor, Jane W Newburger, Carolyn Dunbar Masterson, Linda M Lambert, Danielle Hollenbeck-Pringle, Felicia L Trachtenberg, Owen White, Brett R Anderson, Margaret C Bell, Phillip T Burch, Eric M Graham, Jonathan R Kaltman, Kirk R Kanter, Carlos M Mery, Christian Pizarro, Marcus S Schamberger, Michael D Taylor, Jeffrey P Jacobs, Sara K Pasquali
BACKGROUND: Data routinely captured in clinical registries may be leveraged to enhance efficiency of prospective research. The quality of registry data for this purpose has not been studied, however. We evaluated the completeness and accuracy of perioperative data within congenital heart centers' local surgical registries. METHODS: Within 12 Pediatric Heart Network (PHN) sites, we evaluated 31 perioperative variables (and their subcategories, totaling 113 unique fields) collected via sites' local clinical registries for submission to The Society of Thoracic Surgeons Database, compared with chart review by PHN research coordinators...
October 7, 2016: Annals of Thoracic Surgery
Brian Kogon, Jan Fernandez, Subhadra Shashidharan, Kirk Kanter, Bahaaldin Alsoufi
BACKGROUND: Patients with total anomalous pulmonary venous connection can be problematic, particularly those with mixed-type pathology. We aimed to describe a cohort of patients with mixed-type anomalous drainage, highlighting the treatment challenges, and identifying risk factors for poor outcome. METHODS: We reviewed the clinical records of patients who underwent repair for mixed-type total anomalous pulmonary venous connection between 1986 and 2015. RESULTS: A total of 19 patients were identified...
September 20, 2016: Cardiology in the Young
Camden Hebson, Wendy Book, Robert W Elder, Ryan Ford, Maan Jokhadar, Kirk Kanter, Brian Kogon, Adrienne H Kovacs, Rebecca D Levit, Michael Lloyd, Kevin Maher, Preeti Reshamwala, Fred Rodriguez, Rene Romero, Thor Tejada, Anne Marie Valente, Gruschen Veldtman, Michael McConnell
"Frontiers in Fontan Failure" was the title of a 2015 conference sponsored by Children's Healthcare of Atlanta and Emory University School of Medicine. In what is hoped to be the first of many such gatherings, speakers and attendees gathered to discuss the problem of long-term clinical deterioration in these patients. Specific focuses included properly defining the problem and then discussing different treatment strategies, both medical and surgical. The health of the liver after Fontan palliation was a particular point of emphasis, as were quality of life and future directions...
September 6, 2016: Congenital Heart Disease
Bahaaldin Alsoufi, Courtney McCracken, Subhadra Shashidharan, Brian Kogon, William Border, Kirk Kanter
BACKGROUND: The two most common surgical strategies for the treatment of neonates born with single-ventricle anomalies associated with aortic arch obstruction are the Norwood operation and pulmonary artery banding plus coarctation repair (PAB+COA). We reviewed characteristics and outcomes of neonates who underwent those two surgical strategies at our institution. METHODS: Between 2002 and 2012, 94 neonates with a single ventricle and aortic arch obstruction (excluding hypoplastic left heart syndrome) underwent Norwood (n = 65) or PAB+COA (n = 29)...
September 1, 2016: Annals of Thoracic Surgery
Bahaaldin Alsoufi, Scott Gillespie, William T Mahle, Shriprasad Deshpande, Brian Kogon, Kevin Maher, Kirk Kanter
Significant noncardiac and genetic abnormalities (NC and GA) are common in neonates with congenital heart defects. We sought to examine current-era effect of those abnormalities on early and late outcomes following cardiac surgery. The method from 2002-2012, 1538 neonates underwent repair (n = 860, 56%) or palliation (n = 678, 44%) of congenital heart defects. Regression models examined the effect of NC and GA on operative results, resource utilization, and late outcomes. Neonates with NC and GA (n = 312, 20%) had higher incidence of prematurity (21% vs 13%; P < 0...
2016: Seminars in Thoracic and Cardiovascular Surgery
Kirk R Kanter
No abstract text is available yet for this article.
2016: Seminars in Thoracic and Cardiovascular Surgery
Phil Botha, Shriprasad R Deshpande, Michael Wolf, Micheal Heard, Bahaaldin Alsoufi, Brian Kogon, Kirk Kanter
BACKGROUND: Management of a patent systemic-pulmonary (SP) shunt and the resulting runoff during extracorporeal membrane oxygenation (ECMO) varies among institutions. We have used a strategy of increased flow without surgical reduction of the shunt diameter, and here report our results with this strategy. METHODS: In this database review of 169 successive veno-arterial ECMO runs performed between 2002 and 2013 in infants and neonates, ECMO flow, time to achieve lactate clearance, normal pH, and negative fluid balance were compared in patients with shunts and those without shunts...
September 2016: Journal of Thoracic and Cardiovascular Surgery
Bahaaldin Alsoufi, Scott Gillespie, Dennis Kim, Subhadra Shashidharan, Kirk Kanter, Kevin Maher, Brian Kogon
BACKGROUND: Differences in right ventricle and tricuspid valve structure compared with left ventricle and mitral valve structure make them less equipped to support the systemic circulation long term, with subsequent systemic right ventricle failure. We examined the effect of dominant ventricle morphology on single ventricle palliation outcomes. METHODS: We grouped 530 neonates who underwent first-stage palliation into two groups based on dominant ventricle morphology: right dominant ventricle (RV group; n = 302, 57%) and left dominant ventricle or functional single ventricle with two well-formed ventricles (LV group; n = 228, 43%)...
August 2016: Annals of Thoracic Surgery
Bahaaldin Alsoufi, Brian Schlosser, Courtney McCracken, Brian Kogon, Kirk Kanter, William Border, Ritu Sachdeva
BACKGROUND: Aortopulmonary window (APW) is a rare congenital defect that is often associated with other cardiac lesions. We analyzed our operative strategy to determine whether this had any relationship with outcomes. METHODS: Early and late outcomes of 40 children who underwent APW repair at our institution during a 20-year period (1994 to 2013) were analyzed. RESULTS: Median age at time of the operation was 22 days (interquartile range, 9 to 63 days), and median weight was 3...
August 2016: Annals of Thoracic Surgery
Makoto Mori, Courtney McCracken, Kevin Maher, Brian Kogon, William Mahle, Kirk Kanter, Bahaaldin Alsoufi
OBJECTIVE: After neonatal cardiac surgery, a number of patients need a prolonged stay in the intensive care unit (ICU). Those patients require tremendous resources and strain the capacity of cardiac units. To date, little knowledge of early and late survival for this challenging population exists. METHODS: From 2002 to 2012, 108 neonates required a postoperative ICU stay >30 days. Multivariable regression analyses examined factors associated with hospital death and late survival...
September 2016: Journal of Thoracic and Cardiovascular Surgery
William T Mahle, Jeffrey P Jacobs, Marshall L Jacobs, Sunghee Kim, Paul M Kirshbom, Sara K Pasquali, Erle H Austin, Kirk R Kanter, Susan C Nicolson, Kevin D Hill
BACKGROUND: There is increasing interest in reducing the duration of mechanical ventilation after pediatric cardiac operations. However, the contemporary use of an early extubation strategy and its effect on clinical outcomes is poorly understood. METHODS: Data from The Society of Thoracic Surgeons Congenital Heart Surgery Database (2010 to 2013) were analyzed to determine the association of early extubation with postoperative length of stay (PLOS). Two operations were analyzed: complete repair of tetralogy of Fallot (TOF) in patients older than 45 days and the Fontan procedure...
September 2016: Annals of Thoracic Surgery
Udit Agarwal, Amanda W Smith, Kristin M French, Archana V Boopathy, Alex George, David Trac, Milton E Brown, Ming Shen, Rong Jiang, Janet D Fernandez, Brian E Kogon, Kirk R Kanter, Baahaldin Alsoufi, Mary B Wagner, Manu O Platt, Michael E Davis
UNLABELLED: Children with congenital heart diseases have increased morbidity and mortality, despite various surgical treatments, therefore warranting better treatment strategies. Here we investigate the role of age of human pediatric cardiac progenitor cells (hCPCs) on ventricular remodeling in a model of juvenile heart failure. hCPCs isolated from children undergoing reconstructive surgeries were divided into 3 groups based on age: neonate (1 day to 1 month), infant (1 month to 1 year), and child (1 to 5 years)...
July 2016: Stem Cells Translational Medicine
Jean d'Amour Ndahimana, David J Riedel, Mutagoma Mwumvaneza, Dieudone Sebuhoro, Jean Claude Uwimbabazi, Marthe Kubwimana, Jules Mugabo, Augustin Mulindabigwi, Catherine Kirk, Steve Kanters, Jamie I Forrest, Linda L Jagodzinski, Sheila A Peel, Muhayimpundu Ribakare, Robert R Redfield, Sabin Nsanzimana
OBJECTIVE: To evaluate HIV drug resistance (HIVDR) and determinants of virological failure in a large cohort of patients receiving first-line tenofovir-based antiretroviral therapy (ART) regimens. METHODS: A nationwide retrospective cohort from 42 health facilities was assessed for virological failure and development of HIVDR mutations. Data were collected at ART initiation and at 12 months of ART on patients with available HIV-1 viral load (VL) and ART adherence measurements...
July 2016: Tropical Medicine & International Health: TM & IH
Bahaaldin Alsoufi, Courtney McCracken, Brian Schlosser, Ritu Sachdeva, Andrew Well, Brian Kogon, William Border, Kirk Kanter
BACKGROUND: Management of infants with heterotaxy syndrome and functional single ventricle is complicated due to associated cardiac and extracardiac anomalies. We report current era palliation results. METHODS: Between 2002 and 2012, 67 infants with heterotaxy syndrome underwent multistage palliation. Competing risks analyses modeled events after surgery (death vs Glenn procedure) and examined factors associated with survival. In addition, early and late outcomes following first-stage palliation surgery were compared with a matched contemporaneous control group of patients with nonheterotaxy single ventricle anomalies...
May 2016: Journal of Thoracic and Cardiovascular Surgery
Kirk R Kanter
Previous studies have reported that children with a prior Fontan procedure have decreased survival after heart transplantation. We examined 273 primary pediatric heart transplants. Since 1988, 33 (12.1%) of 273 children <18 years old undergoing primary heart transplantation had a Fontan procedure 3.7 ± 4.3 years before transplantation. Compared with 240 (87.9%) non-Fontan primary transplants, the Fontan patients were older (8.8 ± 5.2 vs 6.6 ± 5.9 years; P = .023), but were similar in presensitization and pre-transplant clinical status...
2016: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Bahaaldin Alsoufi, Shriprasad Deshpande, Courtney McCracken, Brian Kogon, Robert Vincent, William T Mahle, Kirk Kanter
OBJECTIVES: Paediatric heart transplantation is performed to salvage children with end-stage heart failure from various underlying pathologies. Despite several developments in all management aspects of transplantation candidates, the effect of those advances on outcomes has not been consistent. We report our institutional experience with focus on examining era effect on early and late survival. METHODS: Between 1988 and 2015, 320 children underwent heart transplantation...
March 31, 2016: European Journal of Cardio-thoracic Surgery
Bahaaldin Alsoufi, Scott Gillespie, Makoto Mori, Martha Clabby, Kirk Kanter, Brian Kogon
OBJECTIVES: The modified Blalock-Taussig shunt (BTS) is utilized to palliate neonates born with restrictive pulmonary blood flow including those with single ventricle (SV) or biventricular (BV) cardiac anomalies. We aim in the current study to report palliation outcomes of neonates with BTS and to examine factors affecting death and progression to the subsequent stage of palliation or repair. METHODS: Between 2002 and 2012, 341 patients underwent BTS including 175 with SV and 166 with BV anomalies...
July 2016: European Journal of Cardio-thoracic Surgery
Ida Rune, Bidda Rolin, Christian Larsen, Dennis Sandris Nielsen, Jenny E Kanter, Karin E Bornfeldt, Jens Lykkesfeldt, Karsten Buschard, Rikke Kaae Kirk, Berit Christoffersen, Johannes Josef Fels, Knud Josefsen, Pernille Kihl, Axel Kornerup Hansen
The importance of the gut microbiota (GM) in disease development has recently received increased attention, and numerous approaches have been made to better understand this important interplay. For example, metabolites derived from the GM have been shown to promote atherosclerosis, the underlying cause of cardiovascular disease (CVD), and to increase CVD risk factors. Popular interest in the role of the intestine in a variety of disease states has now resulted in a significant proportion of individuals without coeliac disease switching to gluten-free diets...
2016: PloS One
M Jeyakanthan, P J Meloncelli, L Zou, T L Lowary, I Larsen, S Maier, K Tao, J Rusch, R Chinnock, N Shaw, M Burch, K Beddows, L Addonizio, W Zuckerman, E Pahl, J Rutledge, K R Kanter, C W Cairo, J M Buriak, D Ross, I Rebeyka, L J West
Organ transplantation from ABO blood group-incompatible (ABOi) donors requires accurate detection, effective removal and subsequent surveillance of antidonor antibodies. Because ABH antigen subtypes are expressed differently in various cells and organs, measurement of antibodies specific for the antigen subtypes in the graft is essential. Erythrocyte agglutination, the century-old assay used clinically, does not discriminate subtype-specific ABO antibodies and provides limited information on antibody isotypes...
May 2016: American Journal of Transplantation
Bahaaldin Alsoufi, William T Mahle, Cedric Manlhiot, Shriprasad Deshpande, Brian Kogon, Brian W McCrindle, Kirk Kanter
BACKGROUND: Following the Norwood operation, unfavorable hemodynamic or anatomic factors might disqualify children from progressing through subsequent palliative surgeries necessitating listing for heart transplantation. Those patients often have immune, clinical, or anatomic risk factors that could preclude donor allocation, increase operative risk, and diminish late survival. We studied transplantation outcomes in those patients using the Pediatric Heart Transplant Study database. METHODS: A total of 253 children who had prior Norwood were listed for transplantation (1993-2012)...
January 2016: Journal of Thoracic and Cardiovascular Surgery
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