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https://www.readbyqxmd.com/read/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#1
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29618662/human-mait-cells-exit-peripheral-tissues-and-recirculate-via-lymph-in-steady-state-conditions
#2
Valentin Voillet, Marcus Buggert, Chloe K Slichter, Julia D Berkson, Florian Mair, Mary M Addison, Yoav Dori, Gregory Nadolski, Maxim G Itkin, Raphael Gottardo, Michael R Betts, Martin Prlic
Mucosal-associated invariant T cells (MAIT cells) recognize bacterial metabolites as antigen and are found in blood and tissues, where they are poised to contribute to barrier immunity. Recent data demonstrate that MAIT cells located in mucosal barrier tissues are functionally distinct from their blood counterparts, but the relationship and circulation of MAIT cells between blood and different tissue compartments remains poorly understood. Previous studies raised the possibility that MAIT cells do not leave tissue and may either be retained or undergo apoptosis...
April 5, 2018: JCI Insight
https://www.readbyqxmd.com/read/29580790/recognition-of-neonatal-lymphatic-flow-disorder-fetal-mr-findings-and-postnatal-mr-lymphangiogram-correlation
#3
David M Biko, Jordan A Johnstone, Yoav Dori, Teresa Victoria, Edward R Oliver, Maxim Itkin
RATIONALE AND OBJECTIVES: This study aimed to describe prenatal and postnatal imaging features and outcomes of neonates with neonatal lymphatic disorders (NLDs). MATERIALS AND METHODS: An institutional review board-approved search of the radiology database for patients with NLD identified five patients. Inclusion criteria include prenatal imaging (fetal magnetic resonance [MR] imaging and ultrasound) and postnatal three-dimensional T2 Sampling Perfection with Application optimized Contrasts using different flip angle Evolution (SPACE) and dynamic contrast-enhanced MR lymphangiography within 6 months of life...
March 23, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29134238/a-comparison-of-anterograde-versus-retrograde-approaches-for-neonatal-balloon-aortic-valvuloplasty
#4
Namrita Mozumdar, Edmund Burke, Melissa Schweizer, Matthew J Gillespie, Yoav Dori, Hari K Narayan, Jonathan J Rome, Andrew C Glatz
In neonates requiring balloon aortic valvuloplasty, both anterograde and retrograde approaches are feasible. A recent comparison of these two approaches is lacking. A retrospective cohort study of neonates at a single center undergoing BAV from 9/00 to 7/14 was performed. Records were reviewed including pre- and post-intervention echocardiograms and catheterization data. Comparisons of acute efficacy and procedural safety were made based on type of approach utilized. Forty-two neonates underwent BAV. Eleven cases utilized exclusively an anterograde approach, while 31 included a retrograde approach (including 4 with both approaches used)...
November 13, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29098350/reintervention-burden-and-vessel-growth-after-surgical-reimplantation-of-a-pulmonary-artery-during-childhood
#5
Stephan J Wu, Tacy Downing, Christopher Mascio, Matthew J Gillespie, Yoav Dori, Jonathan J Rome, Andrew C Glatz
Children requiring reimplantation of a branch pulmonary artery (PA) are at risk for postoperative stenosis and impaired growth of the reimplanted PA. Outcomes and risk factors for reintervention and impaired growth are incompletely described. We reviewed data on patients who underwent reimplantation of a branch PA between 1/1/99 and 5/1/15 at a single center. The primary outcome was reintervention to treat postoperative stenosis. The secondary outcome was "catch-up" growth (faster diameter growth of the affected PA compared with the unaffected PA from the preoperative to follow-up measurements...
November 2, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28938967/increasing-propensity-to-pursue-operative-closure-of-atrial-septal-defects-following-changes-in-the-instructions-for-use-of-the-amplatzer-septal-occluder-device-an-observational-study-using-data-from-the-pediatric-health-information-systems-database
#6
MULTICENTER STUDY
Michael L O'Byrne, Russell T Shinohara, Elena K Grant, Joshua P Kanter, Matthew J Gillespie, Yoav Dori, Jonathan J Rome, Andrew C Glatz
Concern for device erosion following transcatheter treatment of atrial septal defects (TC-ASD) led in 2012 to a United States Food and Drug Administration panel review and changes in the instructions for use of the Amplatzer Septal Occluder (ASO) device. No studies have assessed the effect of these changes on real-world practice. To this end a multicenter observational study was performed to evaluate trends in the treatment of ASD. METHODS: A retrospective observational study was performed using data from the Pediatric Health Information Systems database of all patients with isolated ASD undergoing either TC-ASD or operative ASD closure (O-ASD) from January 1, 2007, to September 30, 2015, hypothesizing that the propensity to pursue O-ASD increased beginning in 2013...
October 2017: American Heart Journal
https://www.readbyqxmd.com/read/28619193/protein-losing-enteropathy-in-patients-with-congenital-heart-disease
#7
Maxim Itkin, David A Piccoli, Gregory Nadolski, Jack Rychik, Aaron DeWitt, Erin Pinto, Jonathan Rome, Yoav Dori
BACKGROUND: Protein-losing enteropathy (PLE), characterized by loss of proteins in the intestine, is a devastating complication in patients with congenital heart disease. The cause of PLE is unknown, but lymphatic involvement has been suspected. OBJECTIVES: The authors evaluated the use of lymphangiographic imaging and liver lymphatic embolization as a treatment for PLE. METHODS: This was a single-center, retrospective review of imaging and interventions used in 8 consecutive patients with liver lymphatic embolization and congenital heart disease with elevated central venous pressure complicated by PLE...
June 20, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28494978/post-operative-chylothorax-in-patients-with-congenital-heart-disease
#8
Jill J Savla, Maxim Itkin, Joseph W Rossano, Yoav Dori
BACKGROUND: Post-operative chylothorax in patients with congenital heart disease is a challenging problem with substantial morbidity and mortality. Currently, the etiology of chylothorax is poorly understood and treatment options are limited. OBJECTIVES: This study aimed to report lymphatic imaging findings, determine the mechanism of chylothorax after cardiac surgery, and analyze the outcomes of lymphatic embolization. METHODS: We conducted a retrospective review of 25 patients with congenital heart disease and post-operative chylothorax who presented for lymphatic imaging and intervention between July 2012 and August 2016...
May 16, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28183988/molecular-imaging-of-vulnerable-coronary-plaque-a-pathophysiologic-perspective
#9
Sandeep Krishnan, Yuka Otaki, Mhairi Doris, Leandro Slipczuk, Yoav Arnson, Mathieu Rubeaux, Damini Dey, Piotr Slomka, Daniel S Berman, Balaji Tamarappoo
Atherothrombotic events in coronary arteries are most often due to rupture of unstable plaque resulting in myocardial infarction. Radiolabeled molecular imaging tracers directed toward cellular targets that are unique to unstable plaque can serve as a powerful tool for identifying high-risk patients and for assessing the potential of new therapeutic approaches. Two commonly available radiopharmaceuticals-(18)F-FDG and (18)F-NaF-have been used in clinical research for imaging coronary artery plaque, and ongoing clinical studies are testing whether there is an association between (18)F-NaF uptake and future atherothrombotic events...
March 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27993320/novel-lymphatic-imaging-techniques
#10
REVIEW
Yoav Dori
The lymphatic system plays an important role in immune regulation, transport of metabolites, and fluid balance. The key circulatory role of the lymphatic system is to transport fluid from tissue back into the venous system via lymphovenous connections. Despite the centuries-old recognition of this key role, there has been poor understanding of lymphatic flow pathophysiology because of a lack of a simple reliable noninvasive clinical lymphatic imaging method. This lack of clinical imaging has limited the treatment options for patients with lymphatic flow disorders...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27662847/implantation-of-the-medtronic-harmony-transcatheter-pulmonary-valve-improves-right-ventricular-size-and-function-in-an-ovine-model-of-postoperative-chronic-pulmonary-insufficiency
#11
Rosanne C Schoonbeek, Satoshi Takebayashi, Chikashi Aoki, Toru Shimaoka, Matthew A Harris, Gregory L Fu, Timothy S Kim, Yoav Dori, Jeremy McGarvey, Harold Litt, Wobbe Bouma, Gerald Zsido, Andrew C Glatz, Jonathan J Rome, Robert C Gorman, Joseph H Gorman, Matthew J Gillespie
BACKGROUND: Pulmonary insufficiency is the nexus of late morbidity and mortality after transannular patch repair of tetralogy of Fallot. This study aimed to establish the feasibility of implantation of the novel Medtronic Harmony transcatheter pulmonary valve (hTPV) and to assess its effect on pulmonary insufficiency and ventricular function in an ovine model of chronic postoperative pulmonary insufficiency. METHODS AND RESULTS: Thirteen sheep underwent baseline cardiac magnetic resonance imaging, surgical pulmonary valvectomy, and transannular patch repair...
October 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27599255/diagnosis-and-treatment-of-lymphatic-plastic-bronchitis-in-adults-using-advanced-lymphatic-imaging-and-percutaneous-embolization
#12
Maxim G Itkin, Francis X McCormack, Yoav Dori
RATIONALE: Plastic bronchitis is a condition characterized by expectoration of branching bronchial casts. Although the mechanism of cast formation in adults with plastic bronchitis remains poorly understood, abnormal pulmonary lymphatic flow resulting in molding of congealing lymphatic fluids in the airway has been documented as a cause of the disease in children with congenital heart disease. OBJECTIVES: To use advanced lymphatic imaging techniques, including dynamic contrast-enhanced magnetic resonance (MR) lymphangiography (DCMRL) and intranodal lymphangiography, to investigate the mechanism of cast formation in adult patients with plastic bronchitis, and to evaluate the therapeutic outcome of percutaneous lymphatic embolization for these patients...
October 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27423853/etiology-and-new-treatment-options-for-patients-with-plastic-bronchitis
#13
EDITORIAL
Yoav Dori, Maxim Itkin
No abstract text is available yet for this article.
August 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27297208/cerebral-lipiodol-embolism-after-lymphatic-embolization-for-plastic-bronchitis
#14
Matthew P Kirschen, Yoav Dori, Maxim Itkin, Daniel J Licht, Rebecca Ichord, Arastoo Vossough
An adolescent with plastic bronchitis due to congenital heart disease had altered mental status after an interventional lymphatic procedure in which lipiodol contrast was used. Neuroimaging revealed cerebral lipiodol embolization due to direct shunting between lymphatic channels and pulmonary veins. Cerebral lipiodol embolization is a potential neurologic morbidity associated with interventional lymphatic procedures.
September 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27189502/the-influence-of-deficient-retro-aortic-rim-on-technical-success-and-early-adverse-events-following-device-closure-of-secundum-atrial-septal-defects-an-analysis-of-the-impact-registry-%C3%A2
#15
MULTICENTER STUDY
Michael L O'Byrne, Matthew J Gillespie, Kevin F Kennedy, Yoav Dori, Jonathan J Rome, Andrew C Glatz
BACKGROUND: Concern regarding aortic erosion has focused attention on the retro-aortic rim in patients undergoing device closure of atrial septal defects (ASD), but its effect on early outcomes is not well studied. METHODS: A multicenter retrospective cohort study of patients undergoing device occlusion of ASD between 1/2011-10/2014 was performed, using data from the IMproving Pediatric and Adult Congenital Treatment Registry. Subjects were divided between those with retro-aortic rim <5 and ≥5 mm...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/26864093/percutaneous-lymphatic-embolization-of-abnormal-pulmonary-lymphatic-flow-as-treatment-of-plastic-bronchitis-in-patients-with-congenital-heart-disease
#16
Yoav Dori, Marc S Keller, Jonathan J Rome, Matthew J Gillespie, Andrew C Glatz, Kathryn Dodds, David J Goldberg, Samuel Goldfarb, Jack Rychik, Maxim Itkin
BACKGROUND: Plastic bronchitis is a potentially fatal disorder occurring in children with single-ventricle physiology, and other diseases, as well, such as asthma. In this study, we report findings of abnormal pulmonary lymphatic flow, demonstrated by MRI lymphatic imaging, in patients with plastic bronchitis and percutaneous lymphatic intervention as a treatment for these patients. METHODS AND RESULTS: This is a retrospective case series of 18 patients with surgically corrected congenital heart disease and plastic bronchitis who presented for lymphatic imaging and intervention...
March 22, 2016: Circulation
https://www.readbyqxmd.com/read/26582175/the-effect-of-radiation-shields-on-operator-exposure-during-congenital-cardiac-catheterisation
#17
Sarosh P Batlivala, Dennise Magill, Marc A Felice, Virginia Jones, Yoav Dori, Matthew J Gillespie, Jonathan J Rome, Andrew C Glatz
Cardiac catheterisation personnel are exposed to occupational radiation and its health risks. Little data exist regarding the efficacy of radiation-protective equipment from congenital catheterisation laboratories (CLs). The authors retrospectively reviewed data in which CL operators wore a radiation dosemeter during catheterizations on patients of >20 kg. A leaded under-table skirt was present in all cases. Three additional radiation-protective devices were utilised at operator discretion: a top extension to the under-table skirt, a ceiling-mounted shield and a disposable patient drape...
December 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/26552510/cost-comparison-of-transcatheter-and-operative-pulmonary-valve-replacement-from-the-pediatric-health-information-systems-database
#18
MULTICENTER STUDY
Michael L O'Byrne, Matthew J Gillespie, Russell T Shinohara, Yoav Dori, Jonathan J Rome, Andrew C Glatz
Outcomes for transcatheter pulmonary valve replacement (TC-PVR) and operative pulmonary valve replacement (S-PVR) are excellent. Thus, their respective cost is a relevant clinical outcome. We performed a retrospective cohort study of children and adults who underwent PVR at age ≥ 8 years from January 1, 2011, to December 31, 2013, at 35 centers contributing data to the Pediatric Health Information Systems database to address this question. A propensity score-adjusted multivariable analysis was performed to adjust for known confounders...
January 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/26541153/intra-procedural-bronchoscopy-to-prevent-bronchial-compression-during-pulmonary-artery-stent-angioplasty
#19
Michael L O'Byrne, Nita Rome, Ramiro W Lizano Santamaria, Anna Hallbergson, Andrew C Glatz, Yoav Dori, Matthew J Gillespie, Samuel Goldfarb, Andrew R Haas, Jonathan J Rome
Stenosis of the pulmonary arteries frequently occurs during staged palliation of hypoplastic left heart syndrome and variants, often necessitating stent angioplasty. A complication of stent angioplasty is compression of the ipsilateral mainstem bronchus. Following such a case, we re-evaluated our approach to PA stent angioplasty in these patients. The incident case is described. A retrospective observational study of children and adults with superior (SCPC) and/or total cavopulmonary connection (TCPC) undergoing left pulmonary artery (LPA) stent angioplasty between January 1, 2005 and January 5, 2014 and subsequent chest CT was performed to assess the incidence of bronchial compression...
March 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/26385453/factors-associated-with-systemic-to-pulmonary-arterial-collateral-flow-in-single-ventricle-patients-with-superior-cavopulmonary-connections
#20
Andrew C Glatz, Neil Harrison, Adam J Small, Yoav Dori, Matthew J Gillespie, Matthew A Harris, Mark A Fogel, Jonathan J Rome, Kevin K Whitehead
OBJECTIVE: Systemic to pulmonary arterial collateral flow (CollF) is common in single ventricle patients with superior cavopulmonary connections (SCPC), although associations with CollF are not well understood. We previously described a method to quantify CollF by cardiac MRI (CMR). We sought to identify factors associated with CollF in a large cross section of patients with SCPC. METHODS: A retrospective observational cohort study of events from birth to study CMR was performed for all patients with SCPC who had CollF quantified by CMR...
November 2015: Heart: Official Journal of the British Cardiac Society
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