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Kirk Kanter

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https://www.readbyqxmd.com/read/29197135/biventricular-support-with-heartware-ventricular-assist-device-in-a-pediatric-patient
#1
Shriprasad R Deshpande, Mallory M Carroll, Chad Mao, William T Mahle, Kirk Kanter
Use of ventricular assist devices is increasing in the pediatric population. This has included the extended use of adult continuous-flow devices in the pediatric population. In a minority of cases, biventricular support may be needed. In these situations, biventricular support with continuous-flow devices can be surgically challenging, and therefore, only few cases have been reported. Here, we present a case of implantation of two HeartWare HVAD devices for biventricular support for a decompensating patient with acute myocarditis as well as present an alternative implantation surgical strategy...
December 1, 2017: Pediatric Transplantation
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
#2
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)...
October 31, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29081908/utility-and-correlation-of-known-anticoagulation-parameters-in-the-management-of-pediatric-ventricular-assist-devices
#3
Ajay K Bhatia, Mouhammad Yabrodi, Mallory Carroll, Silvia Bunting, Kirk Kanter, Kevin O Maher, Shriprasad R Deshpande
AIM: To assess utility and correlation of known anticoagulation parameters in the management of pediatric ventricular assist device (VAD). METHODS: Retrospective study of pediatric patients supported with a Berlin EXCOR VAD at a single pediatric tertiary care center during a single year. RESULTS: We demonstrated associations between activated thromboplastin time (aPTT) and R-thromboelastography (R-TEG) values (rs = 0.65, P < 0.001) and between anti-Xa assay and R-TEG values (rs = 0...
September 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28709664/current-results-of-single-ventricle-palliation-of-patients-with-double-inlet-left-ventricle
#4
Bahaaldin Alsoufi, Courtney McCracken, Kirk Kanter, Subhadra Shashidharan, Brian Kogon
BACKGROUND: Double inlet left ventricle (DILV) is a heterogeneous single ventricle anomaly in which initial presentation, and consequently, timing and palliation mode vary based on morphology and degree of pulmonary or systemic outflow obstruction. Very few reports, mostly old, focused on palliation outcomes of DILV. We report current-era results and examine whether morphologic and subsequently surgical factors influence survival. METHODS: Fifty-eight infants with DILV underwent single ventricle palliation...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669502/the-impact-of-22q11-2-deletion-syndrome-on-surgical-repair-outcomes-of-conotruncal-cardiac-anomalies
#5
COMPARATIVE STUDY
Bahaaldin Alsoufi, Courtney McCracken, Subhadra Shashidharan, Shriprasad Deshpande, Kirk Kanter, Brian Kogon
BACKGROUND: We aim to describe the impact of 22q11.2 deletion syndrome (22q11DS) on clinical characteristics, postoperative course, and early and late outcomes of neonates undergoing surgery for conotruncal anomalies. METHODS: A retrospective review was performed (2002 to 2012) of 224 neonates who underwent surgery for interrupted aortic arch (n = 67), truncus arteriosus (n = 85), or ductal-dependent pulmonary atresia and ventricular septal defect (n = 72). Patients were divided into three groups: group 1, n = 119, no genetic syndrome; group 2, n = 64, 22q11DS; and group 3, n = 41, other genetic syndrome...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28560706/local-hemodynamic-differences-between-commercially-available-y-grafts-and-traditional-fontan-baffles-under-simulated-exercise-conditions-implications-for-exercise-tolerance
#6
Phillip M Trusty, Zhenglun Wei, Michael Tree, Kirk R Kanter, Mark A Fogel, Ajit P Yoganathan, Timothy C Slesnick
Fontan completion, resulting in a total cavopulmonary connection (TCPC), is accomplished using a lateral tunnel (LT), extracardiac conduit (ECC), or recently a bifurcated Y-graft. The local energetic differences between these graft types have not been substantially analyzed under exercise conditions. The present study evaluates the energetic performance of Y-grafts under simulated exercise conditions, compares their performance to the previous LT/ECC Fontan options, and discusses implications for exercise tolerance and hemodynamic predictability...
September 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28109347/how-is-physician-work-valued
#7
REVIEW
Jeffrey P Jacobs, Stephen J Lahey, Francis C Nichols, James M Levett, George Gilbert Johnston, Richard K Freeman, James D St Louis, Julie Painter, Courtney Yohe, Cameron D Wright, Kirk R Kanter, John E Mayer, Keith S Naunheim, Jeffrey B Rich, Joseph E Bavaria
Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued. In 1965, with the dawn of increasingly complex medical care, immense innovation, and the rollout of Medicare, the need for a common language describing medical services and procedures was recognized as being of critical importance...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27834986/echocardiographic-predictors-of-left-ventricular-outflow-tract-obstruction-following-repair-of-atrioventricular-septal-defect
#8
Ginnie L Abarbanell, Gemma Morrow, Michael S Kelleman, Kirk R Kanter, William L Border, Ritu Sachdeva
BACKGROUND: Left ventricular outflow tract obstruction (LVOTO) is a common complication following surgical repair of atrioventricular septal defect (AVSD). OBJECTIVE: We sought to determine predictors of LVOTO based on echocardiograms performed prior to initial repair of AVSD. METHODS: Of the 415 children that had repair of AVSD from 2003 to 2012, 17 children were identified with LVOTO that required surgical intervention. Thirty-four patients with repaired AVSD and no LVOTO served as controls...
May 12, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27726857/completeness-and-accuracy-of-local-clinical-registry-data-for-children-undergoing-heart-surgery
#9
MULTICENTER STUDY
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...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27645915/a-30-year-experience-with-mixed-type-total-anomalous-pulmonary-venous-connection-a-word-of-caution
#10
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...
July 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/27597140/-frontiers-in-fontan-failure-a-summary-of-conference-proceedings
#11
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...
January 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/27592600/palliation-outcomes-of-neonates-born-with-single-ventricle-anomalies-associated-with-aortic-arch-obstruction
#12
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)...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27568146/the-effect-of-noncardiac-and-genetic-abnormalities-on-outcomes-following-neonatal-congenital-heart-surgery
#13
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
https://www.readbyqxmd.com/read/27568143/biventricular-repair-with-a-ross-procedure-after-a-norwood-procedure-a-big-operation-for-a-big-problem
#14
EDITORIAL
Kirk R Kanter
No abstract text is available yet for this article.
2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27530641/extracorporeal-membrane-oxygenator-support-in-infants-with-systemic-pulmonary-shunts
#15
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
https://www.readbyqxmd.com/read/27345094/the-impact-of-dominant-ventricle-morphology-on-palliation-outcomes-of-single-ventricle-anomalies
#16
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
https://www.readbyqxmd.com/read/27207392/current-outcomes-of-surgical-management-of%C3%A2-aortopulmonary-window-and-associated-cardiac-lesions
#17
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
https://www.readbyqxmd.com/read/27174514/outcomes-of-neonates-requiring-prolonged-stay-in-the-intensive-care-unit-after-surgical-repair-of-congenital-heart-disease
#18
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
https://www.readbyqxmd.com/read/27173073/early-extubation-after-repair-of-tetralogy-of-fallot-and-the-fontan-procedure-an-analysis-of-the-society-of-thoracic-surgeons-congenital-heart-surgery-database
#19
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
https://www.readbyqxmd.com/read/27151913/age-dependent-effect-of-pediatric-cardiac-progenitor-cells-after-juvenile-heart-failure
#20
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
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