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Christopher Mascio

Jyoti K Patel, Andrew C Glatz, Reena M Ghosh, Shannon M Jones, Chitra Ravishankar, Christopher Mascio, Meryl S Cohen
BACKGROUND: Intramural ventricular septal defects (VSDs), residual interventricular communications occurring after repair of conotruncal defects, are associated with poor postoperative outcomes. The ability of intraoperative transesophageal echocardiography (TEE) to identify intramural VSDs has not yet been evaluated. METHODS: Intraoperative TEE and postoperative transthoracic echocardiography (TTE) data in all patients undergoing all biventricular repair of conotruncal anomalies in our hospital between January 1, 2006, and June 30, 2013, were reviewed...
September 2016: Journal of Thoracic and Cardiovascular Surgery
Michael Gaies, Sara K Pasquali, Janet E Donohue, Justin B Dimick, Sarah Limbach, Nancy Burnham, Chitra Ravishankar, Richard G Ohye, J William Gaynor, Christopher E Mascio
BACKGROUND: Understanding the seminal complications leading to death after pediatric cardiac surgical procedures may provide opportunities to reduce mortality. This study analyzed all deaths at two pediatric cardiac surgical programs and developed a method to identify the seminal complications and modes of death. METHODS: Trained nurses abstracted all cases of in-hospital mortality meeting inclusion criteria from each site over 5 years (2008 to 2012). Complication definitions were consistent with those of a multicenter clinical registry...
August 2016: Annals of Thoracic Surgery
Andrew M Misfeldt, Roxanne E Kirsch, David J Goldberg, Christopher E Mascio, Maryam Y Naim, Xumei Zhang, Antonio R Mott, Chitra Ravishankar, Joseph W Rossano
OBJECTIVES: Extracorporeal membrane oxygenation is often used in children with single-ventricle anomalies. We aimed to describe extracorporeal membrane oxygenation use in single-ventricle patients to test the hypothesis that despite increasing prevalence, mortality has not improved and overall burden measure by hospital charges and length of stay have increased. DESIGN: Retrospective analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database was performed with sample weighting to generate national estimates...
March 2016: Pediatric Critical Care Medicine
Lisa X Deng, Abigail May Khan, David Drajpuch, Stephanie Fuller, Jonathan Ludmir, Christopher E Mascio, Sara L Partington, Ayesha Qadeer, Lynda Tobin, Adrienne H Kovacs, Yuli Y Kim
Post-traumatic stress disorder (PTSD) is associated with adverse outcomes and increased mortality in cardiac patients. No studies have examined PTSD in the adult congenital heart disease (ACHD) population. The objectives of this study were to assess the prevalence of self-reported symptoms of PTSD in patients with ACHD and explore potential associated factors. Patients were enrolled from an outpatient ACHD clinic and completed several validated measures including the Impact of Event Scale-Revised, PTSD Checklist-Civilian Version, and the Hospital Anxiety and Depression Scale...
March 1, 2016: American Journal of Cardiology
Christopher E Mascio, Thomas L Spray
The use of a right ventricle-to-pulmonary artery (RV-PA) conduit for stage 1 palliation of hypoplastic left heart syndrome is common. A prospective randomized multiinstitutional study revealed that approximately 40% of those receiving this shunt required intervention on the shunt or pulmonary arteries, or both. A technique has been developed to help ameliorate proximal conduit stenosis. We present a new technique to improve distal conduit stenosis and decrease anastomotic bleeding from this site. The technique involves dunking a segment of the shunt into the pulmonary arteries and suture placement in the shunt rings and not in the polytetrafluoroethylene (PTFE)...
December 2015: Annals of Thoracic Surgery
Mahsun Yuerek, Joseph W Rossano, Christopher E Mascio, Robert E Shaddy
Low cardiac output syndrome (LCOS) is a well-described entity occurring in 25-65% of pediatric patients undergoing open-heart surgery. With judicious intensive care management of LCOS, most patients have an uncomplicated postoperative course, and within 24 h after cardiopulmonary bypass, the cardiac function returns back to baseline. Some patients have severe forms of LCOS not responsive to medical management alone, requiring temporary mechanical circulatory support to prevent end-organ injury and to decrease myocardial stress and oxygen demand...
2016: Expert Review of Cardiovascular Therapy
Jyoti K Patel, Andrew C Glatz, Reena M Ghosh, Shannon M Jones, Shobha Natarajan, Chitra Ravishankar, Christopher E Mascio, Thomas L Spray, Meryl S Cohen
BACKGROUND: Intramural ventricular septal defects (VSDs) are interventricular communications through right ventricular free wall trabeculations that can occur after repair of conotruncal anomalies. We assessed the prevalence of residual intramural VSDs and their effect on postoperative course. METHODS AND RESULTS: Children who underwent biventricular repair of a conotruncal anomaly from January 1, 2006, to June 30, 2013, and had a postoperative transthoracic echocardiogram were included...
October 13, 2015: Circulation
Matthew J O'Connor, Britton C Keeshan, Kimberly Y Lin, Dimitrios Monos, Curt Lind, Stephen M Paridon, Christopher E Mascio, Robert E Shaddy, Joseph W Rossano
BACKGROUND: We sought to investigate temporal trends in the methodology of human leukocyte antibody assessment in heart transplantation. METHODS: The United Network for Organ Sharing database was queried from June 2004 to March 2013 to obtain pre-heart transplantation human leukocyte antibody results. The % panel reactive antibody for class I and II antibodies was recorded along with the methodology of assessment. Allosensitization was defined as class I and/or II panel reactive antibody of ≥ 10%...
September 2015: Clinical Transplantation
Anna Hallbergson, Christopher E Mascio, Jonathan J Rome
Early failure of the Fontan circulation is rare in the current era but remains associated with a high mortality rate. Surgical Fontan takedown has evolved as one of the strategies to stabilize the circulation, improve survival, and allow for a future attempt at Fontan completion. We have completed Transcatheter fontan takedown in three patients with extracardiac conduits 0.8-6 months following their Fontan operations. Superior vena cava flow was redirected into only the pulmonary arteries by occluding the conduit with a vascular plug between the pulmonary arteries and fenestration and unrestrictive inferior vena cava flow was redirected into only the atrium by stenting and enlarging the fenestration...
November 2015: Catheterization and Cardiovascular Interventions
Christopher E Mascio
Improved survival, recognition, and management of patients with congenital heart disease have increased the number of pediatric patients with ventricular dysfunction. Many of these patients require mechanical support to bridge to transplant or recovery. Development of pediatric ventricular assist devices has lagged behind adult devices. Until recently, adult devices were used in pediatric patients, with suboptimal results in the smaller patient population. Extracorporeal membrane oxygenation can be life saving, but is a poor choice for long-term support...
January 2015: Artificial Organs
Allison K Black, Usha K Sadanala, Christopher E Mascio, Carlton A Hornung, Bradley B Keller
OBJECTIVE: Infants with "single ventricle" congenital heart disease are at high risk for sudden death following palliative surgical management. We developed a pilot telemedicine project to evaluate the feasibility of using Web-based daily reporting of clinical data with the goal of reducing unexpected admissions and sudden death. SUBJECTS AND METHODS: We enrolled 9 subjects (enrolled subjects [ES]) following surgical palliation over 12 months. Parents electronically transmitted ES daily weight and oxygen saturation and then completed an automated 10-point phone questionnaire on nutrition, activity, and distress...
September 2014: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Jeremy L Herrmann, Michael J Lewis, Stephanie Fuller, Christopher E Mascio
No abstract text is available yet for this article.
April 2014: Journal of Thoracic and Cardiovascular Surgery
Christopher E Mascio, Erle H Austin, Jeffrey P Jacobs, Marshall L Jacobs, Amelia S Wallace, Xia He, Sara K Pasquali
OBJECTIVES: Analyses of mechanical circulatory support (MCS) in pediatric heart surgery have primarily focused on single-center outcomes or narrow applications. We describe the patterns of use, patient characteristics, and MCS-associated outcomes across a large multicenter cohort. METHODS: Patients (aged <18 years) in the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database (2000-2010) were included. The characteristics and outcomes of those receiving postoperative MCS were described, and bayesian hierarchical models were used to examine variations in the adjusted MCS rates across institutions...
February 2014: Journal of Thoracic and Cardiovascular Surgery
Sebastian Pagni, Brian L Ganzel, Ramesh Singh, Erle H Austin, Christopher Mascio, Matthew L Williams, Phani V Akella, Jaimin R Trivedi
BACKGROUND: Despite modern advances in surgical care, triple-valve surgery (TVS) remains a challenge and carries a mortality of 10% to 20%. No validated risk score is available for TVS, and the effect of advanced age is unknown. This study examined our results in the modern era with the aim of identifying perioperative predictors of adverse outcomes. METHODS: Between 1997 and 2013, 131 patients (mean age, 67.2±13.4 years) underwent TVS at our institution. Sixty-eight patients (51...
February 2014: Annals of Thoracic Surgery
Sebastian Pagni, Brian L Ganzel, Jaimin R Trivedi, Ramesh Singh, Christopher E Mascio, Erle H Austin, Mark S Slaughter, Matthew L Williams
OBJECTIVE: Surgical repair of acute Type A aortic dissection (AADA) is still associated with high in-hospital mortality. We evaluated the impact of perioperative risk factors on early and midterm survival. METHODS: Retrospective (2002-2011) database analysis at a single institution of 132 consecutive AADA patients (88 male, age 59.8 ± 13.6). All but five patients underwent repair with open distal anastomoses and hypothermic circulatory arrest: aortic valve replacement/root replacement (n=44, 33...
September 2013: Journal of Cardiac Surgery
Sebastian Pagni, Christopher Mascio, Jaimin Trivedi, Jiapeng Huang
Fistulization between the aorta and the right atrium is a rare complication of ascending aortic dissection. Because of the typical haemodynamic unstability, the diagnosis is often made by bedside or intraoperative transoesophageal echocardiography. The treatment is surgical, but with very high mortality. We describe a case of type A aortic dissection complicated with shock and fistulization into the right atrium with the right-to-left shunt through a patent foramen ovale. Surgical repair was successful.
June 2013: Interactive Cardiovascular and Thoracic Surgery
Christopher E Mascio, J William Gaynor
No abstract text is available yet for this article.
September 2012: Journal of Thoracic and Cardiovascular Surgery
George M Pantalos, Sarina Sahetya, Tracy L Merkley, Timothy Horrell, Erle H Austin, Christopher E Mascio
Extracorporeal membrane oxygenation (ECMO) is often used to provide cardiopulmonary support for infants experiencing severe levels of cardiac or respiratory failure. In patients with two ventricles and no intra-atrial communication, ECMO is often complicated by limited venous return to the circuit and marked left atrial hypertension. This condition may be treated by performing an atrial septostomy to create an intentional atrial septal defect (ASD). A pediatric mock circulation with a conduit connecting the left and right atrium was used to examine the size of ASD that would relieve left atrial hypertension and restore acceptable hemodynamics in a 4 to 5 kg infant...
July 2012: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Christopher E Mascio, Sara K Pasquali, Jeffrey P Jacobs, Marshall L Jacobs, Erle H Austin
OBJECTIVE: Outcomes data for adults undergoing congenital heart surgery are limited. Previous analyses used administrative data or focused on single-center outcomes. We describe the most common operations, patient characteristics, and postoperative outcomes using a multicenter clinical database. METHODS: The study included adults (aged ≥ 18 years) listed in the Society of Thoracic Surgeons Congenital Heart Surgery Database (2000-2009). We describe patient characteristics and morbidity and mortality, and examine congenital procedures in the Society of Thoracic Surgeons Adult Cardiac Surgery Database to permit consideration of the primary dataset within a broader context...
November 2011: Journal of Thoracic and Cardiovascular Surgery
Bibhuti B Das, Lawrence Shoemaker, Edward Kim, Christopher E Mascio, Erle H Austin
We report a unique case of severe calcification of the aorta, bilateral coronary ostial stenoses and calcification of the mitral valve and left ventricle due to sarcoidosis. The patient underwent neonatal orthotopic heart transplantation secondary to hypoplastic left heart syndrome and developed hypercalcemia with other features of sarcoidosis at 10 yr of age. The mechanism for severe extra-renal calcification localized to the allograft is poorly understood, but may involve discordant local immune modulation and/or calcification-regulation between graft and host tissues...
August 2012: Pediatric Transplantation
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