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Article ; Online: The Dawn of the Invasive Heart Failure Specialist.

Kassi, Mahwash

JACC. Case reports

2021 Volume 3, Issue 10, Page(s) 1336–1338

Language	English
Publishing date	2021-08-19
Publishing country	Netherlands
Document type	Editorial
ISSN	2666-0849
ISSN (online)	2666-0849
DOI	10.1016/j.jaccas.2021.06.037
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Insights on Infiltrative and Restrictive Cardiomyopathies.

Trachtenberg, Barry / Kassi, Mahwash

Methodist DeBakey cardiovascular journal

2022 Volume 18, Issue 2, Page(s) 1–3

MeSH term(s)	Cardiomyopathies/diagnostic imaging ; Cardiomyopathies/therapy ; Cardiomyopathy, Restrictive ; Humans ; Sarcoidosis
Language	English
Publishing date	2022-03-14
Publishing country	United States
Document type	Editorial
ZDB-ID	2544079-2
ISSN	1947-6108 ; 1947-6108
ISSN (online)	1947-6108
ISSN	1947-6108
DOI	10.14797/mdcvj.1098
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Article ; Online: Acute Circulatory Collapse and Advanced Therapies in Patients with COVID-19 Infection.

Thaker, Rishi / Shah, Aayush / Kim, Ju / Kassi, Mahwash

Methodist DeBakey cardiovascular journal

2021 Volume 17, Issue 5, Page(s) 43–52

Abstract: In the current era of the COVID-19 pandemic, intensive care patients with COVID-19 often develop respiratory failure and acute respiratory distress syndrome. While less frequent, acute circulatory collapse, with or without respiratory failure, has its ... ...

Abstract	In the current era of the COVID-19 pandemic, intensive care patients with COVID-19 often develop respiratory failure and acute respiratory distress syndrome. While less frequent, acute circulatory collapse, with or without respiratory failure, has its own management challenges and nuances. Early identification of acute circulatory collapse requires appropriate imaging, particularly echocardiography, and precise diagnosis of cardiogenic shock using a Swan-Ganz catheter. Escalation to mechanical circulatory support (MCS), such as an intra-aortic balloon pump, Impella, and extracorporeal membrane oxygenation, has been useful in patients with acute circulatory collapse from COVID-19. This condition is associated with high morbidity and mortality, but early recognition of appropriate candidates for specific treatment strategies and escalation to MCS might improve outcomes.
MeSH term(s)	COVID-19 ; Heart-Assist Devices/adverse effects ; Humans ; Intra-Aortic Balloon Pumping/adverse effects ; Pandemics ; SARS-CoV-2 ; Shock, Cardiogenic/diagnosis ; Shock, Cardiogenic/etiology ; Shock, Cardiogenic/therapy
Language	English
Publishing date	2021-12-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2544079-2
ISSN	1947-6108 ; 1947-6094
ISSN (online)	1947-6108
ISSN	1947-6094
DOI	10.14797/mdcvj.1048
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Article: The role of innovative modeling and imaging techniques in improving outcomes in patients with LVAD.

Wilson, Shannon I / Ingram, Katelyn E / Oh, Albert / Moreno, Michael R / Kassi, Mahwash

Frontiers in cardiovascular medicine

2023 Volume 10, Page(s) 1248300

Abstract: Heart failure remains a significant cause of mortality in the United States and around the world. While organ transplantation is acknowledged as the gold standard treatment for end stage heart failure, supply is limited, and many patients are treated ... ...

Abstract	Heart failure remains a significant cause of mortality in the United States and around the world. While organ transplantation is acknowledged as the gold standard treatment for end stage heart failure, supply is limited, and many patients are treated with left ventricular assist devices (LVADs). LVADs extend and improve patients' lives, but they are not without their own complications, particularly the hemocompatibility related adverse events (HRAE) including stroke, bleeding and pump thrombosis. Mainstream imaging techniques currently in use to assess appropriate device function and troubleshoot complications, such as echocardiography and cardiac computed tomography, provide some insight but do not provide a holistic understanding of pump induced flow alterations that leads to HRAEs. In contrast, there are technologies restricted to the benchtop-such as computational fluid dynamics and mock circulatory loops paired with methods like particle image velocimetry-that can assess flow metrics but have not been optimized for clinical care. In this review, we outline the potential role and current limitations of converging available technologies to produce novel imaging techniques, and the potential utility in evaluating hemodynamic flow to determine whether LVAD patients may be at higher risk of HRAEs. This addition to diagnostic and monitoring capabilities could improve prevention and treatment of LVAD-induced complications in heart failure patients.
Language	English
Publishing date	2023-08-24
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2023.1248300
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Article ; Online: Giant Coronary Sinus Complicated by Spontaneous Thrombosis.

Ojukwu, Otito / Zook, Salma / Kleiman, Neal / Lawrie, Gerald / Kassi, Mahwash

Methodist DeBakey cardiovascular journal

2022 Volume 18, Issue 4, Page(s) 89–93

Abstract: Spontaneous coronary sinus thrombosis (CST) is an extremely rare occurrence. Most cases are iatrogenic and related to right heart instrumentation, due to either central line placement or electrophysiology procedures such as pacemaker insertion that ... ...

Abstract	Spontaneous coronary sinus thrombosis (CST) is an extremely rare occurrence. Most cases are iatrogenic and related to right heart instrumentation, due to either central line placement or electrophysiology procedures such as pacemaker insertion that causes direct damage to the endothelial lining. The course can be insidious and may result in a fatal outcome. Diagnosis of CST is challenging, and the syndrome often goes unrecognized. However, in the current era of multimodality imaging, it is possible that this condition will be recognized in more patients. Herein, we present a patient with spontaneous coronary sinus thrombosis that was diagnosed using multimodality imaging and thereafter successfully managed.
MeSH term(s)	Cardiac Catheterization ; Coronary Sinus/diagnostic imaging ; Coronary Thrombosis/complications ; Coronary Thrombosis/diagnostic imaging ; Coronary Vessel Anomalies/complications ; Humans ; Sinus Thrombosis, Intracranial/complications
Language	English
Publishing date	2022-09-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2544079-2
ISSN	1947-6108 ; 1947-6108
ISSN (online)	1947-6108
ISSN	1947-6108
DOI	10.14797/mdcvj.1159
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Article ; Online: Computational investigation of outflow graft variation impact on hemocompatibility profile in LVADs.

Zambrano, Byron A / Wilson, Shannon I / Zook, Salma / Vekaria, Bansi / Moreno, Michael R / Kassi, Mahwash

Artificial organs

2023 Volume 48, Issue 4, Page(s) 375–385

Abstract: Background: Hemocompatibility-related adverse events (HRAE) occur commonly in patients with left ventricular assist devices (LVADs) and add to morbidity and mortality. It is unclear whether the outflow graft orientation can impact flow conditions ... ...

Abstract	Background: Hemocompatibility-related adverse events (HRAE) occur commonly in patients with left ventricular assist devices (LVADs) and add to morbidity and mortality. It is unclear whether the outflow graft orientation can impact flow conditions leading to HRAE. This study presents a simulation-based approach using exact patient anatomy from medical images to investigate the influence of outflow cannula orientation in modulating flow conditions leading to HRAEs. Methods: A 3D model of a proximal aorta and outflow graft was reconstructed from a computed tomography (CT) scan of an LVAD patient and virtually modified to model multiple cannula orientations (n = 10) by varying polar (cranio-caudal) (n = 5) and off-set (anterior-posterior) (n = 2) angles. Time-dependent computational flow simulations were then performed for each anatomical orientation. Qualitative and quantitative hemodynamics metrics of thrombogenicity including time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), endothelial cell platelet activation potential (ECAP), particle residence time (PRT), and platelet activation potential (PLAP) were analyzed. Results: Within the simulations performed, endothelial cell activation potential (ECAP) and particle residence time (PRT) were found to be lowest with a polar angle of 85°, regardless of offset angle. However, polar angles that produced parameters at levels least associated with thrombosis varied when the offset angle was changed from 0° to 12°. For offset angles of 0° and 12° respectively, flow shear was lowest at 65° and 75°, time averaged wall shear stress (TAWSS) was highest at 85° and 35°, and platelet activation potential (PLAP) was lowest at 65° and 45°. Conclusion: This study suggests that computational fluid dynamic modeling based on patient-specific anatomy can be a powerful analytical tool when identifying optimal positioning of an LVAD. Contrary to previous work, our findings suggest that there may be an "ideal" outflow cannula for each individual patient based on a CFD-based hemocompatibility profile.
MeSH term(s)	Humans ; Heart-Assist Devices/adverse effects ; Models, Cardiovascular ; Hydrodynamics ; Aorta/physiology ; Thrombosis/etiology ; Hemodynamics/physiology
Language	English
Publishing date	2023-11-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	441812-8
ISSN	1525-1594 ; 0160-564X
ISSN (online)	1525-1594
ISSN	0160-564X
DOI	10.1111/aor.14679
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Article ; Online: Repeat left ventricular-assisted device exchange and upgrade from second- to third-generation devices in a high-volume single center.

Kassi, Mahwash / Avenatti, Eleonora / Hoang, Khanh-Doan / Zook, Salma / Yousafzai, Rayan / Guha, Ashrith / Bhimaraj, Arvind / Chou, Lin-Chiang Philip / Suarez, Erik E

Artificial organs

2024 Volume 48, Issue 5, Page(s) 536–542

Abstract: Background: Pump exchange is an established strategy to treat LVAD-related complications such as thrombosis, infection, and driveline failure. Pump upgrades with an exchange to newer generation devices are being performed to the advantage of the patient ...

Abstract	Background: Pump exchange is an established strategy to treat LVAD-related complications such as thrombosis, infection, and driveline failure. Pump upgrades with an exchange to newer generation devices are being performed to the advantage of the patient on long-term support. The safety and efficacy of a repeat LVAD exchange with a concomitant upgrade to a third-generation pump have not been reported. Methods: We performed a retrospective analysis of all consecutive patients who underwent a repeat LVAD device exchange and upgrade to HeartMate III (HMIII) at Houston Methodist Hospital between December 2018 and December 2020. Results: Five patients underwent exchange and upgrade to HMIII within the specified timeframe. Four patients had already had two prior exchanges (all HMII to HMII), and one patient had one prior exchange (HVAD to HVAD). In all cases, implantation was performed as destination therapy. The surgical exchange was performed via redo median sternotomy on full cardiopulmonary bypass. No unplanned redo surgery of the device component was required. In-hospital mortality was 20% in this very high-risk population. At 1-, 3-, and 6-month follow-up, all discharged patients were on HMIII support, with no major LVAD-related adverse events reported. Conclusion: We report the feasibility and safety of a repeat pump exchange with an upgrade to HMIII in a high-volume center. The decision for medical therapy versus surgical exchange has to be tailored to individual cases based on risk factors and clinical stability but in expert hands, even a re-redo surgical approach grants options for good medium-term outcomes.
MeSH term(s)	Humans ; Heart Failure/surgery ; Retrospective Studies ; Heart Transplantation ; Heart-Assist Devices/adverse effects ; Hospitals
Language	English
Publishing date	2024-01-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	441812-8
ISSN	1525-1594 ; 0160-564X
ISSN (online)	1525-1594
ISSN	0160-564X
DOI	10.1111/aor.14710
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Article: Patient-specific, echocardiography compatible flow loop model of aortic valve regurgitation in the setting of a mechanical assist device.

Kassi, Mahwash / Filippini, Stefano / Avenatti, Eleonora / Xu, Susan / El-Tallawi, Kinan Carlos / Angulo, Clara I / Vukicevic, Marija / Little, Stephen H

Frontiers in cardiovascular medicine

2023 Volume 10, Page(s) 994431

Abstract: Background: Aortic regurgitation (AR) occurs commonly in patients with continuous-flow left ventricular assist devices (LVAD). No gold standard is available to assess AR severity in this setting. Aim of this study was to create a patient-specific model ... ...

Abstract	Background: Aortic regurgitation (AR) occurs commonly in patients with continuous-flow left ventricular assist devices (LVAD). No gold standard is available to assess AR severity in this setting. Aim of this study was to create a patient-specific model of AR-LVAD with tailored AR flow assessed by Doppler echocardiography. Methods: An echo-compatible flow loop incorporating a 3D printed left heart of a Heart Mate II (HMII) recipient with known significant AR was created. Forward flow and LVAD flow at different LVAD speed were directly measured and AR regurgitant volume (RegVol) obtained by subtraction. Doppler parameters of AR were simultaneously measured at each LVAD speed. Results: We reproduced hemodynamics in a LVAD recipient with AR. AR in the model replicated accurately the AR in the index patient by comparable Color Doppler assessment. Forward flow increased from 4.09 to 5.61 L/min with LVAD speed increasing from 8,800 to 11,000 RPM while RegVol increased by 0.5 L/min (2.01 to 2.5 L/min). Conclusions: Our circulatory flow loop was able to accurately replicate AR severity and flow hemodynamics in an LVAD recipient. This model can be reliably used to study echo parameters and aid clinical management of patients with LVAD.
Language	English
Publishing date	2023-02-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2023.994431
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Article ; Online: Insidious Mass Within a Sinus.

Dhorepatil, Aneesh / Modi, Vivek / Kassi, Mahwash / Chamsi-Pasha, Mohammad A R / Ewton, April / Allen, Dyron / Mallah, Mouaz H Al

Methodist DeBakey cardiovascular journal

2023 Volume 19, Issue 1, Page(s) 92–95

Abstract: A 75-year-old patient was incidentally found to have an intracardiac mass by echocardiography. Subsequent cardiac magnetic resonance imaging and cardiac positron emission tomography confirmed a large and possibly malignant mass extending from the right ... ...

Abstract	A 75-year-old patient was incidentally found to have an intracardiac mass by echocardiography. Subsequent cardiac magnetic resonance imaging and cardiac positron emission tomography confirmed a large and possibly malignant mass extending from the right atrium into the coronary sinus. The patient underwent an intracardiac echocardiography guided biopsy, which revealed diffuse B-cell lymphoma, and is currently undergoing rituximab, etoposide, vincristine, cyclophosphamide, and doxorubicin (R-EPOCH)-based chemotherapy.
MeSH term(s)	Humans ; Aged ; Lymphoma, Large B-Cell, Diffuse/diagnostic imaging ; Lymphoma, Large B-Cell, Diffuse/drug therapy ; Lymphoma, Large B-Cell, Diffuse/pathology ; Rituximab/therapeutic use ; Cyclophosphamide/therapeutic use ; Vincristine/therapeutic use ; Prednisone/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Doxorubicin/therapeutic use ; Positron-Emission Tomography ; Echocardiography
Chemical Substances	Rituximab (4F4X42SYQ6) ; Cyclophosphamide (8N3DW7272P) ; Vincristine (5J49Q6B70F) ; Prednisone (VB0R961HZT) ; Doxorubicin (80168379AG)
Language	English
Publishing date	2023-12-29
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2544079-2
ISSN	1947-6108 ; 1947-6108
ISSN (online)	1947-6108
ISSN	1947-6108
DOI	10.14797/mdcvj.1316
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Article ; Online: Sex Disparities in Left Ventricular Assist Device Implantation: Delayed Presentation and Worse Right Heart Failure.

Lamba, Harveen K / Kherallah, Riyad / Nair, Ajith P / Shafii, Alexis E / Loor, Gabriel / Kassi, Mahwash / Chatterjee, Subhasis / Rogers, Joseph G / Civitello, Andrew B / Liao, Kenneth K

ASAIO journal (American Society for Artificial Internal Organs : 1992)

2024

Abstract: We explored whether women undergo continuous-flow left ventricular assist device (CF-LVAD) implantation in later stages of heart failure (HF) than men, evidenced by worse preoperative right HF (RHF). We also compared two propensity models with and ... ...

Abstract	We explored whether women undergo continuous-flow left ventricular assist device (CF-LVAD) implantation in later stages of heart failure (HF) than men, evidenced by worse preoperative right HF (RHF). We also compared two propensity models with and without preoperative RHF to assess its effect on outcomes. INTERMACS was queried from July 2008 to December 2017. Propensity model 1 matched men and women on age ≥50 years, HF etiology, body surface area, INTERMACS class, comorbidities, device strategy, temporary mechanical circulatory support, and device type. Model 2 included these variables plus LV end-diastolic diameter, right atrial pressure/pulmonary capillary wedge pressure, pulmonary artery pulsatility index, and right ventricular ejection fraction. The primary outcome was all-cause mortality. Secondary outcomes comprise RHF, rehospitalization, renal dysfunction, stroke, and device malfunction. In model 1, characteristics were comparable between 3,195 women and 3,195 men, except women more often had preoperative RHF and postoperative right VAD support and had worse 1 year and overall survival. In model 2, after propensity matching for additional risk factors for preoperative RHF, 1,119 women and 1,119 men had comparable post-LVAD implant RVAD use and survival. These findings suggest that women present more often with biventricular failure and after implantation have higher RHF and mortality rates.
Language	English
Publishing date	2024-01-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	759982-1
ISSN	1538-943X ; 0162-1432 ; 1058-2916
ISSN (online)	1538-943X
ISSN	0162-1432 ; 1058-2916
DOI	10.1097/MAT.0000000000002134
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