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  1. Article ; Online: A Cautiously Optimistic Metric for Patients Undergoing Durable Left Ventricular Assist Device Implantation.

    Kaczorowski, David J / Chu, Danny

    JAMA surgery

    2023  Volume 158, Issue 4, Page(s) e228138

    MeSH term(s) Humans ; Heart-Assist Devices ; Heart Failure/surgery ; Prosthesis Design ; Thoracic Surgical Procedures ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2023-04-12
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2022.8138
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  2. Article ; Online: The 10 Commandments of Microaxial Temporary Left Ventricular Assist Devices.

    Hess, Nicholas R / Ziegler, Luke A / Kaczorowski, David J

    Innovations (Philadelphia, Pa.)

    2022  Volume 17, Issue 5, Page(s) 368–376

    MeSH term(s) Humans ; Heart-Assist Devices ; Shock, Cardiogenic ; Myocardial Infarction
    Language English
    Publishing date 2022-12-16
    Publishing country United States
    Document type Editorial
    ISSN 1559-0879
    ISSN (online) 1559-0879
    DOI 10.1177/15569845221134514
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  3. Article ; Online: Cardiac Catheterization via Direct Access of Venoarterial Extracorporeal Membrane Oxygenation Circuit.

    Ziegler, Luke A / Gupta, Anuj / Bang, Vigyan / Kaczorowski, David J

    Innovations (Philadelphia, Pa.)

    2023  Volume 18, Issue 3, Page(s) 282–285

    Abstract: Obtaining arterial access for cardiac catheterization can be both challenging and morbid in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). While catheterization performed by obtaining endovascular access through the ... ...

    Abstract Obtaining arterial access for cardiac catheterization can be both challenging and morbid in patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). While catheterization performed by obtaining endovascular access through the ECMO circuit itself has been described, all previous cases utilized a Y-connector and accessory tubing limb. We report a novel technique whereby arterial access was obtained directly via standard VA-ECMO arterial return tubing, through which coronary angiography was successfully performed in a 67-year-old woman. This technique may reduce the incidence of morbidity attendant with obtaining vascular accesses in patients on ECMO without requiring insertion of new circuit components.
    MeSH term(s) Female ; Humans ; Aged ; Extracorporeal Membrane Oxygenation/methods ; Cardiac Catheterization/methods ; Coronary Angiography ; Femoral Artery ; Incidence ; Retrospective Studies ; Catheterization, Peripheral/methods
    Language English
    Publishing date 2023-05-05
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 1559-0879
    ISSN (online) 1559-0879
    DOI 10.1177/15569845231170231
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  4. Article ; Online: The history of cardiac xenotransplantation

    Nicholas R. Hess / David J. Kaczorowski

    Frontiers in Transplantation, Vol

    early attempts, major advances, and current progress

    2023  Volume 2

    Abstract: In light of ongoing shortage of donor organs for transplantation, alternative sources for donor organ sources have been examined to address this supply-demand mismatch. Of these, xenotransplantation, or the transplantation of organs across species, has ... ...

    Abstract In light of ongoing shortage of donor organs for transplantation, alternative sources for donor organ sources have been examined to address this supply-demand mismatch. Of these, xenotransplantation, or the transplantation of organs across species, has been considered, with early applications dating back to the 1600s. The purpose of this review is to summarize the early experiences of xenotransplantation, with special focus on heart xenotransplantation. It aims to highlight the important ethical concerns of animal-to-human heart xenotransplantation, identify the key immunological barriers to successful long-term xenograft survival, as well as summarize the progress made in terms of development of pharmacological and genetic engineering strategies to address these barriers. Lastly, we discuss more recent attempts of porcine-to-human heart xenotransplantation, as well as provide some commentary on the current concerns and possible applications for future clinical heart xenotransplantation.
    Keywords heart–heart transplantation ; transplant ; pig ; genetic engineering ; xenotransplant ; baboon ; Specialties of internal medicine ; RC581-951
    Subject code 170 ; 610
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Heart Donation and Preservation: Historical Perspectives, Current Technologies, and Future Directions.

    Hess, Nicholas R / Ziegler, Luke A / Kaczorowski, David J

    Journal of clinical medicine

    2022  Volume 11, Issue 19

    Abstract: Heart transplantation has become the accepted treatment for advanced heart failure, with over 4000-5000 performed in the world annually. Although the number of yearly transplants performed has been increasing over the last decade, the number of ... ...

    Abstract Heart transplantation has become the accepted treatment for advanced heart failure, with over 4000-5000 performed in the world annually. Although the number of yearly transplants performed has been increasing over the last decade, the number of candidates in need of transplantation continues to grow at an even faster rate. To distribute these scarce and precious resources equitably, donor heart placement is based on clinical need with priority given to those who are more critically ill. As a result, donors are matched with recipient candidates over increasingly farther distances, which may subject these organs to longer ischemic times. One of the mainstays of successful heart transplantation is successful organ preservation while the donor organ is ex vivo from the time of donor procurement to recipient implantation. In order to adapt to a new era of heart transplantation where organs are shared across wider ranges, preservation strategies must evolve to accommodate longer ischemia times while mitigating the harmful sequalae of ischemia-reperfusion injury. Additionally, in order to address the ever-growing supply demand mismatch of donor organs, evolving perfusion technologies may allow for further evaluation of donor grafts outside of conventional acceptance practices, thus enlarging the effective donor pool. Herein this review, we discuss the history of organ preservation, current strategies and modalities employed in current practice, along with developing technologies in preclinical stages. Lastly, we introduce the concept of donation after circulatory death (DCD), which has been until recently a largely unexplored avenue of heart donation that relies much on current preservation techniques.
    Language English
    Publishing date 2022-09-28
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11195762
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  6. Article ; Online: Left Atrial Appendage Occlusion Device Placement Aborted Because of Coronary Artery Bypass Graft.

    Yin, John / Hillsdon-Smith, Garret / Rhinehart, Zachary J / Kaczorowski, David / Jain, Sandeep / Subramanian, Harikesh

    JACC. Case reports

    2023  Volume 9, Page(s) 101740

    Abstract: Left atrial appendage occlusion device (LAAO) implantation among patients who have had coronary artery bypass grafting can be challenging. We report a case of scheduled LAAO device implantation that was aborted due to the anomalous course of a bypass ... ...

    Abstract Left atrial appendage occlusion device (LAAO) implantation among patients who have had coronary artery bypass grafting can be challenging. We report a case of scheduled LAAO device implantation that was aborted due to the anomalous course of a bypass graft that appeared to be adherent to the left atrial appendage. (
    Language English
    Publishing date 2023-01-30
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2666-0849
    ISSN (online) 2666-0849
    DOI 10.1016/j.jaccas.2023.101740
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  7. Article ; Online: Minimally invasive durable mechanical circulatory support: Don't hit them while they're down.

    Shah, Aakash / Kaczorowski, David J

    The Journal of thoracic and cardiovascular surgery

    2019  Volume 157, Issue 5, Page(s) e269–e270

    MeSH term(s) Cardiac Surgical Procedures ; Cardiovascular System
    Language English
    Publishing date 2019-01-31
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2018.12.059
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  8. Article ; Online: Utilization of cardiac graft with single coronary artery for orthotopic heart transplantation.

    Hess, Nicholas R / Keebler, Mary E / Fabrizio, Carly A / Kaczorowski, David J

    Journal of cardiothoracic surgery

    2022  Volume 17, Issue 1, Page(s) 291

    Abstract: Background: Anomalous coronary arteries arise in a small subset of the population, with each configuration conveying a varying degree of long-term risk. The utilization of cardiac grafts with these anomalies have not been well described.: Case ... ...

    Abstract Background: Anomalous coronary arteries arise in a small subset of the population, with each configuration conveying a varying degree of long-term risk. The utilization of cardiac grafts with these anomalies have not been well described.
    Case presentation: An anomalous single coronary artery with the left main coronary artery arising from the right coronary ostium was discovered in a 40-year old male evaluated for cardiac donation. After evaluation, this heart was successfully procured and utilized for orthotopic heart transplantation.
    Conclusion: In this report, we demonstrate that in select cases, a cardiac graft with single coronary artery anatomy can be successfully procured and transplanted with excellent outcomes.
    MeSH term(s) Humans ; Male ; Adult ; Heart Transplantation ; Coronary Vessel Anomalies/surgery ; Tissue Donors ; Coronary Artery Disease/surgery
    Language English
    Publishing date 2022-11-18
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2227224-0
    ISSN 1749-8090 ; 1749-8090
    ISSN (online) 1749-8090
    ISSN 1749-8090
    DOI 10.1186/s13019-022-02035-x
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  9. Article ; Online: How to Do It: Transbrachial Impella Placement to Facilitate Percutaneous Coronary Intervention.

    Waterford, Stephen D / Schwartz, Bryan G / Ferdinand, Francis D / Kaczorowski, David J / Rizzoni, Walter E

    Innovations (Philadelphia, Pa.)

    2023  Volume 18, Issue 4, Page(s) 372–375

    Abstract: A 64-year-old man with diffusely diseased iliofemoral vessels and an ejection fraction of 20% to 25% presented with a non-ST elevation myocardial infarction and proximal left anterior descending (LAD) and left circumflex (LCx) coronary artery disease, ... ...

    Abstract A 64-year-old man with diffusely diseased iliofemoral vessels and an ejection fraction of 20% to 25% presented with a non-ST elevation myocardial infarction and proximal left anterior descending (LAD) and left circumflex (LCx) coronary artery disease, with a chronically occluded right coronary artery. The iliofemoral system was not suitable for Impella placement, and bilateral axillary arteries were heavily calcified. The proximal left brachial artery was chosen for placement of both an Impella CP (Abiomed, Danvers, MA, USA) and percutaneous coronary intervention (PCI) sheath through a graft sewn to the brachial artery in this single-access technique. A 6 mm graft was sewn to the brachial artery, through which the Impella CP was placed. The Impella CP sheath was then used to introduce a 7F sheath for PCI. Successful PCI with drug-eluting stents was carried out to the LAD and LCx arteries, the Impella was weaned and removed, and the graft was stapled. The patient was discharged without any access or PCI complications. This report demonstrates the feasibility of the single-access Impella technique through a brachial artery cutdown approach.
    MeSH term(s) Male ; Humans ; Middle Aged ; Percutaneous Coronary Intervention/methods ; Treatment Outcome ; Coronary Artery Disease/surgery ; Axillary Artery
    Language English
    Publishing date 2023-08-08
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 1559-0879
    ISSN (online) 1559-0879
    DOI 10.1177/15569845231190870
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  10. Article ; Online: Impact of 2018 allocation system change on outcomes in patients with durable left ventricular assist device as bridge to transplantation: A UNOS registry analysis.

    Hess, Nicholas R / Ziegler, Luke A / Keebler, Mary E / Hickey, Gavin W / Kaczorowski, David J

    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

    2023  Volume 42, Issue 7, Page(s) 925–935

    Abstract: Background: This study compared outcomes of patients waitlisted for orthotopic heart transplantation with durable left ventricular assist devices (LVAD) before and after the October 18, 2018 heart allocation policy change.: Methods: The United ... ...

    Abstract Background: This study compared outcomes of patients waitlisted for orthotopic heart transplantation with durable left ventricular assist devices (LVAD) before and after the October 18, 2018 heart allocation policy change.
    Methods: The United Network of Organ Sharing database was queried to identify 2 cohorts of adult candidates with durable LVAD listed within seasonally-matched, equal-length periods before (old policy era [OPE]) and after the policy change (new policy era [NPE]). The primary outcomes were 2-year survival from the time of initial waitlisting, as well as 2-year post-transplant survival. Secondary outcomes included incidence of transplantation from the waitlist and de-listing due to either death or clinical deterioration.
    Results: A total of 2,512 candidates were waitlisted, 1,253 within the OPE and 1,259 within the NPE. Candidates under both policies had similar 2-year survival after waitlisting, as well as a similar cumulative incidence of transplantation and de-listing due to death and/or clinical deterioration. A total of 2,560 patients were transplanted within the study period, 1,418 OPE and 1,142 within the NPE. Two-year post-transplant survival was similar between policy eras, however, the NPE was associated with a higher incidence of post-transplant stroke, renal failure requiring dialysis, and a longer hospital length of stay.
    Conclusions: The 2018 heart allocation policy has conferred no significant impact on overall survival from the time of initial waitlisting among durable LVAD-supported candidates. Similarly, the cumulative incidence of transplantation and waitlist mortality have also been largely unchanged. For those undergoing transplantation, a higher degree of post-transplant morbidity was observed, though survival was not impacted.
    MeSH term(s) Adult ; Humans ; Heart Failure/surgery ; Heart Failure/epidemiology ; Heart-Assist Devices/adverse effects ; Clinical Deterioration ; Heart Transplantation/adverse effects ; Registries
    Language English
    Publishing date 2023-02-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1062522-7
    ISSN 1557-3117 ; 1053-2498
    ISSN (online) 1557-3117
    ISSN 1053-2498
    DOI 10.1016/j.healun.2023.02.002
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