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Edward Soltesz

Mehdi H Shishehbor, Nader Moazami, Michael Zhen-Yu Tong, Shinya Unai, W H Wilson Tang, Edward G Soltesz
For patients in cardiogenic shock, several devices can serve as a "bridge," ie, provide circulatory support and allow the patient to live long enough to recover or to receive a heart transplant or a long-term device. Options include an intra-aortic balloon pump, TandemHeart, Impella, extracorporeal membrane oxygenation (ECMO), and CentriMag. Which device to use depends on individual patient needs, local expertise, and anatomic and physiologic considerations.
April 2017: Cleveland Clinic Journal of Medicine
Rajendra H Mehta, Jeffrey D Leimberger, Sean van Diepen, James Meza, Alice Wang, Rachael Jankowich, Robert W Harrison, Douglas Hay, Stephen Fremes, Andra Duncan, Edward G Soltesz, John Luber, Soon Park, Michael Argenziano, Edward Murphy, Randy Marcel, Dimitri Kalavrouziotis, Dave Nagpal, John Bozinovski, Wolfgang Toller, Matthias Heringlake, Shaun G Goodman, Jerrold H Levy, Robert A Harrington, Kevin J Anstrom, John H Alexander
Background Levosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery. Methods In a multicenter, randomized, placebo-controlled, phase 3 trial, we evaluated the efficacy and safety of levosimendan in patients with a left ventricular ejection fraction of 35% or less who were undergoing cardiac surgery with the use of cardiopulmonary bypass. Patients were randomly assigned to receive either intravenous levosimendan (at a dose of 0...
March 19, 2017: New England Journal of Medicine
Edward Soltesz, Marc Gillinov
No abstract text is available yet for this article.
May 2017: Journal of Thoracic and Cardiovascular Surgery
Ryu Komatsu, Huseyin Oguz Yilmaz, Jing You, C Allen Bashour, Shobana Rajan, Edward G Soltesz, Daniel I Sessler, Alparslan Turan
BACKGROUND: Statins may reduce the risk of pulmonary and neurologic complications after cardiac surgery. METHODS: The authors acquired data for adults who had coronary artery bypass graft, valve surgery, or combined procedures. The authors matched patients who took statins preoperatively to patients who did not. First, the authors assessed the association between preoperative statin use and the primary outcomes of prolonged ventilation (more than 24 h), pneumonia (positive cultures of sputum, transtracheal fluid, bronchial washings, and/or clinical findings consistent with the diagnosis of pneumonia), and in-hospital all-cause mortality, using logistic regressions...
May 2017: Anesthesiology
Eric E Roselli, Faisal G Bakaeen, Douglas R Johnston, Edward G Soltesz, Michael Z Tong
OBJECTIVES: Considering the chronic and progressive nature of aortic dissection, operative planning must anticipate the need for later interventions. We have increasingly used a modified version of the frozen elephant trunk repair operation to treat these patients. We review the indications, considerations for planning, and important operative details for performing frozen elephant trunk repair for chronic aortic dissection. METHODS: Frozen elephant trunk repair is performed using selective antegrade brain perfusion, direct placement of commercially available stent grafts with suture fixation in the aortic arch, and proximal aortic replacement...
January 2017: European Journal of Cardio-thoracic Surgery
Thoralf M Sundt, Hartzell V Schaff, Edward G Soltesz, Miguel Sousa Uva, David H Adams
No abstract text is available yet for this article.
July 2016: Seminars in Thoracic and Cardiovascular Surgery
Melissa M Levack, Muhammad Aftab, Eric E Roselli, Douglas R Johnston, Edward G Soltesz, A Marc Gillinov, Gösta B Pettersson, Brian Griffin, Richard Grimm, Donald F Hammer, Adil H Al Kindi, Turki B Albacker, Edgardo Sepulveda, Lucy Thuita, Eugene H Blackstone, Joseph F Sabik, Lars G Svensson
BACKGROUND: Less-invasive techniques have previously been described for mitral and aortic valve operations; however, few studies have examined their benefit for aortic root and ascending aorta reconstruction. Using propensity matching, we compared outcomes of patients undergoing proximal aortic operations through a J incision compared with full sternotomy. METHODS: From January 1995 to January 2014, 8,533 patients underwent proximal aortic operations at Cleveland Clinic...
February 2017: Annals of Thoracic Surgery
Faisal G Bakaeen, Eric E Roselli, Douglas R Johnston, Edward G Soltesz, Michael Z Tong, Lars G Svensson
No abstract text is available yet for this article.
November 2016: Journal of Surgical Research
Ryu Komatsu, Natalya Makarova, Jing You, Daniel I Sessler, David G Anthony, Yusuke Kasuya, Edward G Soltesz, Alparslan Turan
OBJECTIVE: To compare incidence of atrial arrhythmia, duration of care, and major complications after cardiac surgery between patients who received etomidate and those who received other induction agents. DESIGN: Retrospective cohort study utilizing propensity score matching. SETTING: A single academic, tertiary care hospital. PARTICIPANTS: Eight thousand nine hundred seventy-eight patients undergoing coronary artery bypass grafting (CABG), valve, or combined valve/CABG surgery requiring cardiopulmonary bypass between January 2005 and December 2010...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
Jay J Idrees, Farhang Yazdchi, Edward G Soltesz, Andrew M Vekstein, Christopher Rodriguez, Eric E Roselli
OBJECTIVE: Patients with complex aortic disease often require multistaged repairs with numerous anastomoses. Manual suturing can be time consuming. To reduce ischemic time, a circular stapling device has been used to facilitate prosthetic graft-to-graft anastomoses. Objectives are to describe this technique and assess outcomes. METHODS: From February 2009 to May 2014, 44 patients underwent complex aortic repair with a circular end-to-end anastomosis (EEA) stapler at Cleveland Clinic...
October 2016: Journal of Thoracic and Cardiovascular Surgery
Michael P Robich, Nicholas K Schiltz, Douglas R Johnston, Stephanie Mick, Amar Krishnaswamy, Rodrigo A Iglesias, Dustin Hang, Eric E Roselli, Edward G Soltesz
INTRODUCTION: The need for permanent pacemaker implantation (PCM) following surgical aortic valve replacement (SAVR) is uncommon but can lead to increased hospital resource utilization. Using nationwide data, we sought to (1) identify hospital, patient, and procedure-level risk factors for PCM after SAVR and (2) determine incremental resource utilization. METHODS: We identified 659,692 patients from the Nationwide Inpatient Sample database who underwent SAVR with or without coronary artery bypass grafting (CABG), mitral valvuloplasty (MVr), or mitral valve replacement (MVR) between 1998 and 2009...
August 2016: Journal of Cardiac Surgery
Jay J Idrees, Eric E Roselli, Ashley M Lowry, Joshua M Reside, Hoda Javadikasgari, Daniel J Johnson, Edward G Soltesz, Douglas R Johnston, Gösta B Pettersson, Eugene H Blackstone, Joseph F Sabik, Lars G Svensson
BACKGROUND: Guidelines supporting the decision to replace the aorta in patients with chronic asymptomatic proximal aortic disease are limited by lack of data on operative risks and long-term effectiveness in relation to aortic size. Therefore, we assessed and compared outcomes of patients undergoing elective isolated proximal aortic replacement for this disease vs replacement during multicomponent operations. METHODS: From January 2006 to January 2011, 1,889 patients underwent proximal aortic replacement (isolated, 212; multicomponent, 1,677) for chronic asymptomatic ascending and arch pathology...
June 2016: Annals of Thoracic Surgery
Alexander Kantorovich, Jodie M Fink, Michael A Militello, Seth R Bauer, Edward G Soltesz, Nader Moazami
Appropriate early anticoagulation after left ventricular assist device (LVAD) implantation has not been established with practices ranging from no anticoagulation to early heparinization. The goal of this study was to evaluate the efficacy and morbidity of three strategies before initiating oral anticoagulation therapy. This was a noninterventional, retrospective, matched historical control cohort study. The primary and secondary endpoints were thrombotic complications (TCs) and bleeding up to 30 days post-LVAD implantation...
March 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Cristian Rosu, Edward G Soltesz
The lack of an ideal prosthetic heart valve leaves surgeons and their patients with a difficult choice at the time of valve replacement surgery. Current guidelines mainly emphasize patient age, contraindications to anticoagulation, and patient desires in their recommendations for the type of prosthesis to implant. Aortic valve replacement is the most frequently performed valve replacement, and 5 articles in recent years have presented important data on outcomes with different prosthesis types. The findings suggest that in young patients, transvalvular prosthesis gradients have an effect on long-term bioprosthesis durability...
2015: Seminars in Thoracic and Cardiovascular Surgery
Jay J Idrees, Nicholas K Schiltz, Douglas R Johnston, Stephanie Mick, Nicholas G Smedira, Joseph F Sabik, Eugene H Blackstone, Lars G Svensson, Edward G Soltesz
BACKGROUND: Postoperative stroke is a devastating complication after aortic valve replacement (AVR). Our objective was to use a large national database to identify the incidence of and risk factors for stroke after AVR, as well as to determine incremental mortality, resource use, and cost of stroke. METHODS: We identified 360,437 patients who underwent isolated surgical AVR between 1998 and 2011 from the National Inpatient Sample (NIH) database. Mean age was 66 ± 32 years...
March 2016: Annals of Thoracic Surgery
Marijan Koprivanac, Marta Kelava, Edward Soltesz, Nicholas Smedira, Samir Kapadia, Anna Brzezinski, Shehab Alansari, Nader Moazami
Mechanical circulatory support devices are the mainstay of treatment for severe cardiogenic shock refractory to pharmacologic therapy. Their evolution over the past few decades has been remarkable with a common theme of developing reliable, less bulky and more easily percutaneously implantable devices. The goal of this article is to review existing devices and advances in technology and provide insight into direction of further research and evolution of mechanical circulatory support devices for temporary support...
2015: Expert Review of Medical Devices
Eric E Roselli, Jay J Idrees, Ashley M Lowry, Khalil Masabni, Edward G Soltesz, Douglas R Johnston, Vidyasagar Kalahasti, Eugene H Blackstone, Joseph F Sabik, Bruce W Lytle, Lars G Svensson
BACKGROUND: Improvements in care have prolonged survival of patients with connective tissue disorders (CTDs), but their entire native aorta remains at risk. Little data are available to guide treatment. Objectives were to characterize patients, describe repair methods, and assess outcomes. METHODS: From 1996 to 2012, 527 patients with CTDs underwent cardiovascular operations. Beyond the root, arch and descending repair was performed in 121 patients (23%) for aneurysm (n = 17), acute complicated dissection (n= 5), or chronic dissection with aneurysmal degeneration (n = 99)...
March 2016: Annals of Thoracic Surgery
Patrick R Vargo, Nicholas K Schiltz, Douglas R Johnston, Nicholas G Smedira, Nader Moazami, Eugene H Blackstone, Edward G Soltesz
A growing number of solid organ transplant survivors require surgery for cardiac disease. We examined the effect of having a previous transplant on outcomes after cardiac surgery in these patients from a population-based perspective. Of 1,709,735 patients who underwent coronary artery bypass grafting, valve, or thoracic aorta surgery from 2004 to 2008 in the Nationwide Inpatient Sample, 3,535 patients (0.21%) had a previous organ transplant (2,712 kidney, 738 liver, 300 pancreas). Multivariate logistic regression analysis and propensity score matching were used to determine the effect of a previous solid organ transplant on outcomes...
December 15, 2015: American Journal of Cardiology
Michael P Robich, Andrew Flagg, Damien J LaPar, David D Odell, William Stein, Muhammad Aftab, Kathleen S Berfield, Amanda L Eilers, Shawn S Groth, John F Lazar, Asad A Shah, Danielle A Smith, Elizabeth H Stephens, Cameron T Stock, Walter F DeNino, Vakhtang Tchantchaleishvili, Edward G Soltesz
BACKGROUND: With increased time and quality pressures, it may be more difficult for residents in cardiothoracic surgery residency programs to get independent operative experience. That may lead residents to inaccurately report their role as "surgeon" to meet American Board of Thoracic Surgery (ABTS) case requirements. METHODS: The 2013 In-Training Examination surveyed 312 cardiothoracic surgery residents and was used to contrast residents in traditional 2-year and 3-year cardiothoracic surgery residencies (traditional, n = 216) with those in 6-year integrated or 3+4-year programs (integrated, n = 96)...
January 2016: Annals of Thoracic Surgery
Jay J Idrees, Eric E Roselli, Charles M Wojnarski, Ke Feng, Muhammad Aftab, Douglas R Johnston, Edward G Soltesz, Joseph F Sabik, Lars G Svensson
OBJECTIVE: Staged elephant trunk (ET) repair is a commonly performed procedure for extensive aortic disease. A significant proportion of patients with predominantly proximal aortic pathology often have in addition a moderately dilated descending aorta (<5 cm) that can progress over time. Objectives were to characterize patients, determine completion rate after prophylactic stage 1 ET, and assess outcomes. METHODS: From 1992 to 2012, a total of 572 patients underwent stage 1 ET for degenerative aneurysm and dissection at Cleveland Clinic...
November 2015: Journal of Thoracic and Cardiovascular Surgery
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