A5018217422- Mechanical Circulatory Support Devices
- Cardiac and Coronary Surgery Techniques
- Congenital Heart Disease Studies
- Cardiac Arrest and Resuscitation
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiac Valve Diseases and Treatments
- Cardiac Ischemia and Reperfusion
- Transplantation: Methods and Outcomes
- Blood transfusion and management
- Anesthesia and Neurotoxicity Research
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Organ Transplantation Techniques and Outcomes
- Fuel Cells and Related Materials
- Aortic Disease and Treatment Approaches
- Cardiovascular and Diving-Related Complications
- Respiratory Support and Mechanisms
- Acute Myocardial Infarction Research
- Heparin-Induced Thrombocytopenia and Thrombosis
- Patient Safety and Medication Errors
- Anesthesia and Sedative Agents
- Blood donation and transfusion practices
- Congenital Diaphragmatic Hernia Studies
- Venous Thromboembolism Diagnosis and Management
- Intensive Care Unit Cognitive Disorders
- Peripheral Artery Disease Management
Boston Children's Hospital
2015-2024
Boston Children's Museum
2018-2023
Harvard University
2016-2023
Pennsylvania Hospital
2022
Nationwide Children's Hospital
2022
All India Institute of Medical Sciences
2022
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2020
Center for Pain and the Brain
2016
Geisinger Health System
1999
Penn State Milton S. Hershey Medical Center
1999
Cardioplegia is an integral and essential method of myocardial protection for patients all ages requiring cardiac surgery in which the heart must be stopped. Numerous cardioplegia solutions delivery methods have been developed. The del Nido solution has use 18 years at Boston Children’s Hospital. This a unique four parts crystalloid to one part whole blood formulation that generally used single-dose fashion. Although was originally developed pediatric infant patients, its adult expanding....
Sensitization to HLA is a risk factor for adverse outcomes after heart transplantation. Requiring negative prospective CM results in longer waiting times and increased waitlist mortality. We report cohort of sensitized children who underwent transplant despite positive CDC CM+ using protocol antibody depletion at time transplant, followed by serial IVIG administration. All patients <21 yrs old transplantation Boston Children's Hospital from 1/1998 1/2011 were included. compared freedom...
The direct thrombin inhibitor bivalirudin is an option for anticoagulation in patients with heparin induced thrombocytopenia (HIT) requiring cardiopulmonary bypass (CPB). There are a limited number of reports pediatric which has been used CPB. We present the case 11 year old male acute onset heart failure secondary to idiopathic dilated cardiomyopathy that developed thrombosis (HITT). patient was anticoagulated operating room and placed on CPB insertion HeartWare® Ventricular Assist Device...
A 34 year old mother with a history of polyhydraminos and premature rupture membranes presented for an ex utero intrapartum treatment (EXIT) procedure to deliver her week gestation fetus. The fetus had been diagnosed large cervical mass which significantly extended into the right chest. compressed deviated airway major neck vessels posteriorly. Imaging also revealed possible tumor involvement superior vena cava atrium. plan was potential extracorporeal membrane oxygenation (ECMO) during EXIT...
Summary Background Blood transfusion has well‐documented adverse effects. As part of a blood conservation initiative at our center, we began routine use cell saver for all congenital heart surgery performed on cardiopulmonary bypass since 2014. Aims This study aimed to compare rates prior to, and in the first second year after this initiative. We hypothesized that would decrease requirements compared pre group. Methods Consecutive patients under 18 years undergoing were retrospectively...
Gaseous microemboli (GME) are known to be delivered the arterial circulation of patients during cardiopulmonary bypass (CPB). An increased number GME adult CPB has been associated with brain injury and postoperative cognitive dysfunction. The load in children exposed its consequences not well characterized. We sought establish a baseline limb emboli counts conduct for our population requiring surgery congenital heart disease. used detection counting (EDAC) device measure activity 103...
Most institutions performing cardiopulmonary bypass for congenital heart disease patients use an integrated hard shell cardiotomy and venous reservoir attached to oxygenator. It is of paramount importance that the be vented so as not cause pressurization. A pressurized sealed has been reported occur secondary issues with vacuum assisted drainage systems well improper venting in general. We report a case air embolus caused by retrograde propulsion through line patient Fontan circulation. The...
Hypoplastic left heart syndrome (HLHS) is a rare and severe congenital cardiac defect. Approximately 1000 infants are born with HLHS in the United States every year. Healthcare collaboratives over last decade have focused on sharing patient experiences techniques an effort to improve outcomes. In 2010, cardiologists families joined together care of patients by forming National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC). Sixty-six approximately 110 institutions caring...
A 12-year-old boy with Marfan’s syndrome required a biventricular assist device (VAD) after an aortic root replacement. The patient developed acute respiratory distress and escalating ventilator support. We hypothesized that the addition of membrane oxygenator in series would improve gas exchange allow for more lung-protective approach. was placed right VAD resulting blood path atrium to pulmonary artery. Circuit function gauged by monitoring flow pressures periodic circuit inspections...
Cardiopulmonary bypass (CPB) circuits can significantly sequester intravenous anesthetics. Adsorption of medications by our institution's standard circuit (Terumo CAPIOX FX05 oxygenator; noncoated polyvinylchloride tubing) has not been described. We prepared ex vivo CPB with and without oxygenators. Medication combinations studied included midazolam (0.5 mg), fentanyl (50 µg), mg) morphine µg). Medications were administered after obtaining baseline samples. Samples drawn at 2, 5, 15, 30, 60,...
Several authors have described methods to track perfusion and cardiac surgical morbidity mortality as well accidents. There is currently not a standard definition of accident nor there reporting threshold for events which do directly cause known morbidity. We propose the term non-routine (NREs) instead accidents, provide working such. This paper describes program we developed NREs within Cardiovascular Program at Children’s Hospital, Boston. are categorized by type (technique, equipment, or...
Heparin is the primary anticoagulant used during cardiac surgery to prevent thrombosis due cardiopulmonary bypass (CPB)–related activation of hemostatic system. The efficacy heparin in operating room generally determined by activated clotting time (ACT) point-of-care tests performed throughout procedure. In an effort transition Hemochron Elite which requires approximately 1/10th sampling volume blood, we conducted a prospective study 260 pediatric patients undergoing CPB. ACT were CPB with...
Ex situ heart perfusion (ESHP) has proven to be an important and valuable step toward better preservation of donor hearts for transplantation. Currently, few ESHP systems allow a convenient functional physiological evaluation the heart. We sought establish simple system that provides assessment during ESHP. The circuit consists oxygenator, heart–lung machine, heater–cooler unit, anesthesia gas blender, collection funnel. Female Yorkshire pig (n = 10) had del Nido cardioplegia (4°C)...