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Christopher Mascio

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https://www.readbyqxmd.com/read/28821330/systemic-atrioventricular-valve-excision-and-ventricular-assist-devices-in-pediatric-patients
#1
Deipanjan Nandi, Kelley D Miller, Carley M Bober, Tami M Rosenthal, Lisa M Montenegro, Joseph W Rossano, J William Gaynor, Christopher E Mascio
BACKGROUND: Continuous-flow ventricular assist devices (CF VADs) designed for adults are increasingly used in pediatric patients. However, there is greater risk of device inflow obstruction as a result of size and anatomy. METHODS: We reviewed all cases of systemic atrioventricular valve (AVV) excision with HeartWare HVAD (HeartWare, Framingham, MA) implantation in the systemic ventricle performed at our institution from November 2015 to May 2016. RESULTS: AVV excision with CF VAD implantation was undertaken in 3 patients...
August 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28766759/value-of-a-flow-cytometry-crossmatch-in-the-setting-of-a-negative-complement-dependent-cytotoxicity-crossmatch-in-heart-transplant-recipients
#2
Britton C Keeshan, Matthew J O'Connor, Kimberly Y Lin, Dimitrios Monos, Curt Lind, Christopher E Mascio, J Eduardo Rame, Thomas L Spray, Robert E Shaddy, Joseph W Rossano
Complement-dependent cytotoxicity crossmatch (CDCXM) is used for evaluation of preformed HLA-specific antibodies in patients undergoing heart transplantation. Flow cytometry crossmatch (FCXM) is a more sensitive assay and used with increasing frequency. To determine the clinical relevance of a positive FCXM in the context of negative CDCXM in heart transplantation, the United Network for Organ Sharing (UNOS) database was analyzed. Kaplan-Meier analysis and Cox proportional hazard modeling were used to assess graft survival for three different patient cohorts defined by crossmatch results: T-cell and B-cell CDCXM+ ("CDCXM +" cohort), CDCXM- but T-cell and/or B-cell FCXM+ ("FCXM+" cohort), and T-cell/B-cell CDCXM- and FCXM- ("XM-" cohort)...
August 2, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28746082/heartware-ventricular-assist-device-as-a-bridge-to-transplant-in-a-small-boy-with-complicated-kawasaki-disease
#3
Christopher E Mascio, Dhananjay P Malankar, Jonathan J Rome
We report a case of HeartWare ventricular assist device (HVAD) implant as a Bridge-to-Transplant in the smallest and the youngest known patient, a 32-month-old boy (body surface area of 0.66 m2) with known Kawasaki disease and giant coronary artery aneurysms. The disease course was complicated by coronary thromboembolism resulting in acute myocardial infarction, ventricular fibrillation, and cardiac arrest. After short-term support with extracorporeal membrane oxygenation for 7 days and long-term support with an HVAD for 5 months, he underwent heart transplantation and is doing well 2 months after the transplant...
July 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28455909/emergency-department-utilization-in-pediatric-heart-transplant-recipients
#4
Carol A Wittlieb-Weber, Joseph W Rossano, David R Weber, Kimberly Y Lin, Chitra Ravishankar, Christopher E Mascio, Robert E Shaddy, Matthew J O'Connor
We used the NEDS database (2010) to evaluate ED utilization in PED HT recipients compared to other patient populations with focus on characteristics of ED visits, risk factors for admission, and charges. We analyzed 433 ED visits by PED HT recipients (median age 8 [range: 0-18] years). The most common primary diagnosis category was infectious (n=163, 37.6%), with pneumonia being the most common infectious etiology. When compared to all PED visits, HT visits were more likely to result in hospital admission (32...
June 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28287055/congenital-pulmonary-lymphangiectasia-and-early-mortality-after-stage-1-reconstruction-procedures
#5
Jeremy L Herrmann, Mallory L Irons, Christopher E Mascio, Jack Rychik, Thomas L Spray, J William Gaynor, Jennifer E Pogoriler
OBJECTIVES: Pulmonary lymphangiectasia associated with hypoplastic left heart syndrome with an intact or restrictive atrial septum may result from increased left atrial pressure, and is associated with worse outcomes following staged reconstruction due to lung dysfunction and significant hypoxaemia. Our objective was to characterise the incidence of pulmonary lymphangiectasia in cases of early mortality following stage 1 reconstructions. METHODS: An institutional cardiac surgical database was retrospectively searched for patients who died within 30 days following a stage 1 reconstruction between 1 January, 1984 and 31 December, 2013...
September 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28283942/comparison-of-blood-viscoelasticity-in-pediatric-and-adult-cardiac-patients
#6
COMPARATIVE STUDY
M Keith Sharp, Mary Gregg, Guy Brock, Neema Nair, Sarina Sahetya, Erle H Austin, Christopher Mascio, Mark D Slaughter, George M Pantalos
Evidence is accumulating that blood flow patterns in the cardiovascular system and in cardiovascular devices do, in some instances, depend on blood viscoelasticity. Thus, to better understand the challenges to providing circulatory support and surgical therapies for pediatric and adult patients, viscous and elastic components of complex blood viscoelasticity of 31 pediatric patients were compared to those of 29 adult patients with a Vilastic-3 rheometer. A random effects model with categorical age covariates found statistically significant differences between pediatric and adult patients for log viscosity (p = 0...
June 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28096041/advance-care-planning-in-adults-with-congenital-heart-disease-a-patient-priority
#7
Lisa X Deng, Lacey P Gleason, Abigail M Khan, David Drajpuch, Stephanie Fuller, Leah A Goldberg, Christopher E Mascio, Sara L Partington, Lynda Tobin, Yuli Y Kim, Adrienne H Kovacs
BACKGROUND: Adult congenital heart disease (ACHD) patients with moderate or great defect complexity are at risk for premature death. Although early engagement in advance care planning (ACP) is recommended, previous research suggests that it seldom occurs. METHODS: This study investigated ACHD patient preferences for ACP and factors that impact preferences. ACHD patients completed an ACP preferences questionnaire, the Hospital Anxiety and Depression Scale and a measure of attachment styles...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28031423/neurological-injury-and-cerebral-blood-flow-in-single-ventricles-throughout-staged-surgical-reconstruction
#8
Mark A Fogel, Christine Li, Okan U Elci, Tom Pawlowski, Peter J Schwab, Felice Wilson, Susan C Nicolson, Lisa M Montenegro, Laura Diaz, Thomas L Spray, J William Gaynor, Stephanie Fuller, Christopher Mascio, Marc S Keller, Matthew A Harris, Kevin K Whitehead, Jim Bethel, Arastoo Vossough, Daniel J Licht
BACKGROUND: Patients with a single ventricle experience a high rate of brain injury and adverse neurodevelopmental outcome; however, the incidence of brain abnormalities throughout surgical reconstruction and their relationship with cerebral blood flow, oxygen delivery, and carbon dioxide reactivity remain unknown. METHODS: Patients with a single ventricle were studied with magnetic resonance imaging scans immediately prior to bidirectional Glenn (pre-BDG), before Fontan (BDG), and then 3 to 9 months after Fontan reconstruction...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/27834765/a-comparison-of-perioperative-management-of-anomalous-aortic-origin-of-a-coronary-artery-between-an-adult-and-pediatric-cardiac-center
#9
MULTICENTER STUDY
Jeremy L Herrmann, Leah A Goldberg, Abigail M Khan, Sara L Partington, Julie A Brothers, Christopher E Mascio, Thomas L Spray, Yuli Y Kim, Stephanie Fuller
BACKGROUND: Anomalous aortic origin of a coronary artery (AAOCA) presents in varying age-groups. Assuming management algorithms differ between pediatric and adult institutions, we compared the perioperative management of patients with AAOCA at two such centers. METHODS: A retrospective review was conducted at a pediatric and an adult institution of patients 14 years or older who underwent surgical repair of AAOCA between January 2000 and May 2014. RESULTS: Twenty patients from the pediatric center (median age: 16...
November 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27183884/accuracy-of-transesophageal-echocardiography-in-the-identification-of-postoperative-intramural-ventricular-septal-defects
#10
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
https://www.readbyqxmd.com/read/27154145/seminal-postoperative-complications-and-mode-of-death-after-pediatric-cardiac-surgical-procedures
#11
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/26808622/outcomes-of-single-ventricle-patients-supported-with-extracorporeal-membrane-oxygenation
#12
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
https://www.readbyqxmd.com/read/26803381/prevalence-and-correlates-of-post-traumatic-stress-disorder-in-adults-with-congenital-heart-disease
#13
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
https://www.readbyqxmd.com/read/26652546/distal-dunk-for-right-ventricle-to-pulmonary-artery-shunt-in-stage-1-palliation
#14
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
https://www.readbyqxmd.com/read/26560361/postoperative-management-of-heart-failure-in-pediatric-patients
#15
REVIEW
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
https://www.readbyqxmd.com/read/26246174/intramural-ventricular-septal-defect-is-a-distinct-clinical-entity-associated-with-postoperative-morbidity-in-children-after-repair-of-conotruncal-anomalies
#16
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
https://www.readbyqxmd.com/read/26172275/changes-in-the-methodology-of-pre-heart-transplant-human-leukocyte-antibody-assessment-an-analysis-of-the-united-network-for-organ-sharing-database
#17
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
https://www.readbyqxmd.com/read/25945427/transcatheter-fontan-takedown
#18
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
https://www.readbyqxmd.com/read/25626575/the-use-of-ventricular-assist-device-support-in-children-the-state-of-the-art
#19
REVIEW
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
https://www.readbyqxmd.com/read/25083905/challenges-in-implementing-a-pediatric-cardiovascular-home-telehealth-project
#20
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
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