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Article ; Online: Cryoablation Cox-maze Surgery: Nitrous Oxide or Argon? Putting the Debate on Ice.

Schill, Matthew R / Melby, Spencer J

2022 Volume 114, Issue 6, Page(s) 2252

MeSH term(s)	Humans ; Cryosurgery ; Maze Procedure ; Argon ; Nitrous Oxide ; Ice
Chemical Substances	Argon (67XQY1V3KH) ; Nitrous Oxide (K50XQU1029) ; Ice
Language	English
Publishing date	2022-01-18
Publishing country	Netherlands
Document type	Journal Article ; Comment
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2021.12.049
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Article ; Online: Surgical options for aortic root aneurysm disease: which procedure, which patient.

Schill, Matthew R / Kachroo, Puja

Current opinion in cardiology

2021 Volume 36, Issue 6, Page(s) 683–688

Abstract: Purpose of review: Several surgical repair strategies are available for patients with aortic root aneurysms. This review summarizes the indications for surgery, surgical treatment options, as well their associated outcomes.: Recent findings: Despite ... ...

Abstract	Purpose of review: Several surgical repair strategies are available for patients with aortic root aneurysms. This review summarizes the indications for surgery, surgical treatment options, as well their associated outcomes. Recent findings: Despite the development and increasing adoption of valve sparing aortic root replacement, most patients with aortic root aneurysms still undergo placement of a composite valved graft. Valve sparing aortic root replacement may have a lower rate of bleeding and thrombotic complications during long-term follow-up with excellent long-term survival and low rates of aortic valve reintervention. Summary: Patients with aortic root aneurysms who are symptomatic or reach the recommended size criteria should undergo surgical repair. Most patients receive composite valve graft conduits with good outcomes. The presence of normal aortic leaflet tissue and minimal regurgitation, including those with connective tissue disorders, should be evaluated for valve sparing aortic root replacement. Valve sparing procedures are durable and obviate the need for lifelong anticoagulation and avoid the risk of structural degeneration of bioprosthetic valves.
MeSH term(s)	Aorta/surgery ; Aortic Aneurysm, Thoracic/surgery ; Aortic Valve/surgery ; Heart Valve Prosthesis Implantation ; Humans ; Treatment Outcome
Language	English
Publishing date	2021-08-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645186-x
ISSN	1531-7080 ; 0268-4705
ISSN (online)	1531-7080
ISSN	0268-4705
DOI	10.1097/HCO.0000000000000902
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Zs.A 2556: Show issues

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Article ; Online: Percutaneous decannulation reduces procedure length and rates of groin wound infection in patients on venoarterial extracorporeal membrane oxygenation.

Roberts, Sophia H / Schumer, Erin M / Sullivan, Mary / Grotberg, John / Jenkins, Bianca / Fischer, Irene / Damiano, Marci / Schill, Matthew R / Masood, Muhammad F / Kotkar, Kunal / Pawale, Amit

JTCVS open

2024 Volume 18, Page(s) 80–86

Abstract: Objective: Open decannulation from femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) carries high risk of morbidity, including groin wound infection. This study evaluated the impact of percutaneous decannulation on rates of groin wound ... ...

Abstract	Objective: Open decannulation from femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) carries high risk of morbidity, including groin wound infection. This study evaluated the impact of percutaneous decannulation on rates of groin wound infection in patients decannulated from femoral VA-ECMO. Methods: Between January 1, 2022, and April 30, 2023, 47 consecutive patients received percutaneous femoral VA-ECMO and survived to decannulation. A percutaneous suture-mediated closure device was used for decannulation in patients with relatively smaller arterial cannulas. Patients with larger arterial cannulas or unsuccessful percutaneous closures underwent surgical cutdown and repair of the femoral artery. The primary outcome was arterial site wound infection following decannulation. Results: Among the 47 patients who survived to decannulation from VA-ECMO, 21 underwent percutaneous decannulation and 27 underwent surgical cutdown. One patient underwent 2 VA-ECMO runs, one with percutaneous decannulation and one with surgical cutdown. Percutaneous decannulation was attempted in 22 patients, with 21 of 22 (95.5%) success rate. Decannulation procedure length was significantly shorter in the percutaneous group (79 minutes vs 148 minutes, Conclusions: Percutaneous decannulation may reduce decannulation procedure length and rate of groin wound infection in patients who survive to decannulation from VA-ECMO.
Language	English
Publishing date	2024-01-26
Publishing country	Netherlands
Document type	Journal Article
ISSN	2666-2736
ISSN (online)	2666-2736
DOI	10.1016/j.xjon.2024.01.012
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Article ; Online: Sinus Rhythm Atrial Electrocardiographic Imaging in Patients With Mitral Regurgitation: Clues to the Substrate for Atrial Fibrillation.

Schill, Matthew R / Vijayakumar, Ramya / Yates, Tari-Ann / McGilvray, Martha M O / Zemlin, Christian W / Schuessler, Richard B / Rudy, Yoram / Damiano, Ralph J

Circulation. Arrhythmia and electrophysiology

2024 , Page(s) e012666

Language	English
Publishing date	2024-04-17
Publishing country	United States
Document type	Letter
ZDB-ID	2426129-4
ISSN	1941-3084 ; 1941-3149
ISSN (online)	1941-3084
ISSN	1941-3149
DOI	10.1161/CIRCEP.123.012666
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Zs.A 6667: Show issues

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Article ; Online: Delayed-enhancement cardiac magnetic resonance imaging detects disease progression in patients with mitral valve disease and atrial fibrillation.

Yates, Tari-Ann / Vijayakumar, Ramya / McGilvray, Martha / Khiabani, Ali J / Razo, Nicholas / Sinn, Laurie / Schill, Matthew R / Marrouche, Nassir / Zemlin, Christian / Damiano, Ralph J

JTCVS open

2023 Volume 16, Page(s) 292–302

Abstract: Objectives: The mechanism by which mitral valve (MV) disease leads to atrial fibrillation (AF) remains poorly understood. Delayed-enhancement cardiac magnetic resonance imaging (DE-MRI) has been used to assess left atrial (LA) fibrosis in patients with ... ...

Abstract	Objectives: The mechanism by which mitral valve (MV) disease leads to atrial fibrillation (AF) remains poorly understood. Delayed-enhancement cardiac magnetic resonance imaging (DE-MRI) has been used to assess left atrial (LA) fibrosis in patients with lone AF before catheter ablation; however, few studies have used DE-MRI to assess MV-induced LA fibrosis in patients with or without AF undergoing MV surgery. Methods: Between March 2018 and September 2022, 38 subjects were enrolled; 15 age-matched controls, 14 patients with lone mitral regurgitation (MR), and 9 patients with MR and AF (MR + AF). Indexed LA volume, total LA wall, and regional LA posterior wall (LAPW) enhancement were defined by the DE-MRI. One-way analysis of variance was performed. Results: LA volume and LA enhancement were associated (r = 0.451, Conclusions: Patients with MR + AF had significantly more total and LAPW fibrosis compared with both controls and lone MR. Volume and delayed enhancement were associated, but there was no difference between MR and MR + AF.
Language	English
Publishing date	2023-08-17
Publishing country	Netherlands
Document type	Journal Article
ISSN	2666-2736
ISSN (online)	2666-2736
DOI	10.1016/j.xjon.2023.07.024
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Article ; Online: Minimally Invasive Mitral Valve Surgery With Concomitant Cox Maze Procedure Is as Effective as a Median Sternotomy With Decreased Morbidity.

Yates, Tari-Ann / McGilvray, Martha / Vinyard, Connor / Sinn, Laurie / Razo, Nicholas / He, June / Roberts, Harold G / Schill, Matthew R / Zemlin, Christian / Damiano, Ralph J

Innovations (Philadelphia, Pa.)

2023 Volume 18, Issue 6, Page(s) 565–573

Abstract: Objective: A right minithoracotomy (RMT) is a minimally invasive surgical approach that has been increasingly performed for the concomitant Cox maze IV procedure (CMP) and mitral valve surgery (MVS). Little is known regarding whether long-term rhythm ... ...

Abstract	Objective: A right minithoracotomy (RMT) is a minimally invasive surgical approach that has been increasingly performed for the concomitant Cox maze IV procedure (CMP) and mitral valve surgery (MVS). Little is known regarding whether long-term rhythm and survival outcomes are affected by the RMT as compared with the traditional median sternotomy (MS) approach. Methods: Between April 2004 and April 2021, 377 patients underwent the concomitant CMP and MVS, of whom 38% had RMT. Propensity score matching yielded 116 pairs. Freedom from atrial tachyarrhythmias (ATA) was assessed with prolonged monitoring annually for 8 years. Survival, rhythm, and perioperative outcomes were compared. Results: The unmatched RMT cohort had a greater freedom from ATA recurrence at 1 year (99% vs 90%, Conclusions: Early 1-year and 3-year freedom from ATA recurrence was better in the RMT cohort compared with the MS cohort. Despite longer operative times, the RMT cohort had shorter lengths of stay, fewer postoperative transfusions, and fewer pacemakers placed.
MeSH term(s)	Humans ; Sternotomy/methods ; Mitral Valve/surgery ; Maze Procedure ; Treatment Outcome ; Retrospective Studies ; Minimally Invasive Surgical Procedures/methods
Language	English
Publishing date	2023-11-27
Publishing country	United States
Document type	Journal Article
ISSN	1559-0879
ISSN (online)	1559-0879
DOI	10.1177/15569845231209974
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Article ; Online: Performance of an Irrigated Bipolar Radiofrequency Ablation Clamp on Explanted Human Hearts.

Yates, Tari-Ann / McGilvray, Martha / Schill, Matthew R / Barron, Lauren / Razo, Nick / Roberts, Harold G / Melby, Spencer / Zemlin, Christian / Damiano, Ralph J

The Annals of thoracic surgery

2023 Volume 116, Issue 2, Page(s) 307–313

Abstract: Background: Bipolar radiofrequency (RF) clamps are commonly used during surgical ablation for atrial fibrillation (AF). This study examined the efficacy of an irrigated bipolar RF clamp to create transmural lesions in an ex vivo human heart model.: ... ...

Abstract	Background: Bipolar radiofrequency (RF) clamps are commonly used during surgical ablation for atrial fibrillation (AF). This study examined the efficacy of an irrigated bipolar RF clamp to create transmural lesions in an ex vivo human heart model. Methods: Ten donor hearts, turned down for transplantation, were explanted and arrested with cold cardioplegia. The ablations of the Cox Maze IV procedure were performed using the Cardioblate LP (Medtronic, Inc) irrigated bipolar RF clamp. In the first 5 hearts, each lesion was created with a single application of RF, whereas in the remaining 5 hearts, each lesion was created with a double application of RF without unclamping. Each lesion was cross-sectioned and stained with 2,3,5-triphenyl-tetrazolium chloride to assess ablation depth and transmurality. Results: A total of 100 lesions were analyzed. In the single-ablation group, 222 of 260 sections (85%) and 37 of 50 lesions (74%) were transmural. The efficacy improved significantly in the double-ablation group, in which 348 of 359 sections (97%, P < .001) and 46 of 50 lesions (92%, P = .017) were transmural. Overall, in nontransmural lesions, the epicardial fat thickness was significantly greater (1.69 ± 0.70 mm vs 0.45 ±0.10 mm, P < .001) than the transmural lesions. Conclusions: A single ablation on human atrial tissue with an irrigated bipolar RF clamp was insufficient to reliably create transmural lesions, but a double ablation significantly increased the lesion and section transmurality. Nontransmural lesions were associated with significantly thicker layers of epicardial fat, which likely decreased tissue energy delivery due to the higher resistance of fat to current flow.
MeSH term(s)	Humans ; Heart Transplantation ; Catheter Ablation/methods ; Tissue Donors ; Heart Atria/surgery ; Atrial Fibrillation/surgery ; Radiofrequency Ablation
Language	English
Publishing date	2023-03-17
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2023.02.055
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Article ; Online: Minimally Invasive Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy.

Musharbash, Farah N / Schill, Matthew R / Henn, Matthew C / Damiano, Ralph J

Innovations (Philadelphia, Pa.)

2017 Volume 12, Issue 6, Page(s) 489–492

Abstract: Surgical septal myectomy is the treatment of choice for patients with symptomatic hypertrophic obstructive cardiomyopathy refractory to medications. This report describes our minimally invasive approach for performing a septal myectomy via a ... ...

Abstract	Surgical septal myectomy is the treatment of choice for patients with symptomatic hypertrophic obstructive cardiomyopathy refractory to medications. This report describes our minimally invasive approach for performing a septal myectomy via a ministernotomy that has been used at our institution for more than a decade. In particular, patient preparation, surgical technique, and clinical considerations are highlighted. Performed properly, this minimally invasive technique is a feasible and effective approach in our experience.
MeSH term(s)	Cardiac Surgical Procedures/methods ; Cardiomyopathy, Hypertrophic/diagnostic imaging ; Cardiomyopathy, Hypertrophic/surgery ; Echocardiography ; Humans ; Minimally Invasive Surgical Procedures/methods ; Ventricular Outflow Obstruction/diagnostic imaging ; Ventricular Outflow Obstruction/surgery ; Ventricular Septum/diagnostic imaging ; Ventricular Septum/surgery
Language	English
Publishing date	2017-12-12
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ISSN	1559-0879
ISSN (online)	1559-0879
DOI	10.1097/IMI.0000000000000421
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Article ; Online: Is anticoagulation with bivalirudin comparable to heparin for pediatric extracorporeal life support? Results from a high-volume center.

Schill, Matthew R / Douds, Matthew T / Burns, Emily L / Lahart, Michael A / Said, Ahmed S / Abarbanell, Aaron M

Artificial organs

2020 Volume 45, Issue 1, Page(s) 15–21

Abstract: There is a paucity of data regarding the use of direct thrombin inhibitors such as bivalirudin for children on extracorporeal life support (ECLS). We sought to compare the outcomes of children on ECLS anticoagulated with bivalirudin versus heparin. ... ...

Abstract	There is a paucity of data regarding the use of direct thrombin inhibitors such as bivalirudin for children on extracorporeal life support (ECLS). We sought to compare the outcomes of children on ECLS anticoagulated with bivalirudin versus heparin. Patients transitioned from heparin to bivalirudin were treated as a separate group. A single-institution, retrospective review of all consecutive children (neonate to 18 years) placed on ECLS in the cardiac or pediatric intensive care units was performed (June 2018-December 2019). Data collected included demographics, anticoagulation strategy, number of circuit interventions, blood product use on ECLS, survival to decannulation, and survival to discharge. Fifty-four children were placed on ECLS for a total of 56 runs. Demographics and venovenous versus venoarterial ECLS were similar. The bivalirudin group had longer median duration of support compared to the heparin group--11.0 days [IQR 6.2, 23.1] versus 3.3 days [2.1, 6.2], P < .001. Patients switched from heparin to bivalirudin had a similar duration of support (10.3 days [8.3, 18.3]) as those on bilvalirudin alone. However, there was no difference in red blood cell, fresh frozen plasma, or platelet transfusions. There was no difference in the number of circuit interventions, survival to decannulation or discharge. The freedom to first circuit intervention was longer with bivalirudin compared to heparin. Our data suggest that even with longer pediatric ECLS runs on bivalirudin, there were no differences in the outcomes between the heparin and bivalirudin groups, with longer freedom from first circuit intervention with bivalirudin. While this is the largest reported series comparing children on ECLS anticoagulated with heparin versus bivalirudin, larger studies are needed to determine the optimal anticoagulation strategy for this diverse and complicated group of children.
MeSH term(s)	Adolescent ; Anticoagulants/administration & dosage ; Anticoagulants/adverse effects ; Blood Coagulation/drug effects ; Child ; Child, Preschool ; Critical Illness/therapy ; Drug Substitution/statistics & numerical data ; Extracorporeal Membrane Oxygenation/adverse effects ; Extracorporeal Membrane Oxygenation/statistics & numerical data ; Female ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Heparin/administration & dosage ; Heparin/adverse effects ; Hirudins/administration & dosage ; Hirudins/adverse effects ; Hospitals, High-Volume/statistics & numerical data ; Humans ; Infant ; Intensive Care Units, Pediatric/statistics & numerical data ; Male ; Peptide Fragments/administration & dosage ; Peptide Fragments/adverse effects ; Recombinant Proteins/administration & dosage ; Recombinant Proteins/adverse effects ; Retrospective Studies ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control ; Thrombosis/epidemiology ; Thrombosis/etiology ; Thrombosis/prevention & control
Chemical Substances	Anticoagulants ; Hirudins ; Peptide Fragments ; Recombinant Proteins ; Heparin (9005-49-6) ; bivalirudin (TN9BEX005G)
Language	English
Publishing date	2020-08-05
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	441812-8
ISSN	1525-1594 ; 0160-564X
ISSN (online)	1525-1594
ISSN	0160-564X
DOI	10.1111/aor.13758
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Zs.A 1463: Show issues

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Article ; Online: Surgical Ablation of Atrial Fibrillation in Patients With Tachycardia-Induced Cardiomyopathy.

Adademir, Taylan / Khiabani, Ali J / Schill, Matthew R / Sinn, Laurie A / Schuessler, Richard B / Moon, Marc R / Melby, Spencer J / Damiano, Ralph J

The Annals of thoracic surgery

2019 Volume 108, Issue 2, Page(s) 443–450

Abstract: Background: Atrial fibrillation (AF) is a common cause of tachycardia-induced cardiomyopathy (TIC). This study evaluated the outcomes of the Cox-Maze IV procedure in patients with TIC and significant left ventricular dysfunction.: Methods: Between ... ...

Abstract	Background: Atrial fibrillation (AF) is a common cause of tachycardia-induced cardiomyopathy (TIC). This study evaluated the outcomes of the Cox-Maze IV procedure in patients with TIC and significant left ventricular dysfunction. Methods: Between January 2002 and January 2017, 37 consecutive patients with a left ventricular ejection fraction (LVEF) of 0.40 or less underwent stand-alone surgical ablation of AF. After dilated and ischemic cardiomyopathies were excluded, 34 of 37 patients met the criteria for the diagnosis of TIC. Results: Patients were a mean age of 56 ± 11 years, and 24 (70%) had long-standing persistent AF. The median AF duration was 72 months (interquartile range, 9 to 276 months). Seventeen patients (50%) had at least one catheter-based ablation that failed. Mean LVEF was 0.32 ± 0.08. There were 11 patients (32%) with New York Heart Association Functional Classification III/IV symptoms. There was one (3%) 30-day mortality caused by a pulmonary embolus, despite full anticoagulation. At 12 months, freedom from atrial tachyarrhythmias on or off antiarrhythmic drugs was 94% and 89%, respectively. Postoperative echocardiograms were available for 27 of 33 patients (82%). The LVEF improved to a mean of 0.55 ± 0.08 (95% confidence interval, 0.51 to 0.58; p < 0.001). Of the 11 patients with New York Heart Association Functional Classification III/IV symptoms, 8 patients were in class I/II at the last follow-up (p = 0.02). Conclusions: Restoration of sinus rhythm with the Cox-Maze IV was associated with significant improvement in the LVEF in patients with AF and TIC. This retrospective study illustrates the efficacy of the Cox-Maze IV in this patient population both at restoring sinus rhythm and improving ventricular function. Patients with TIC and poor left ventricular function in whom other treatments have failed should be strongly considered for surgical ablation.
MeSH term(s)	Atrial Fibrillation/complications ; Atrial Fibrillation/physiopathology ; Atrial Fibrillation/surgery ; Biopsy ; Cardiomyopathies/diagnosis ; Cardiomyopathies/etiology ; Cardiomyopathies/physiopathology ; Catheter Ablation/methods ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Conduction System/physiopathology ; Heart Rate/physiology ; Humans ; Magnetic Resonance Imaging, Cine ; Male ; Middle Aged ; Myocardium/pathology ; Retrospective Studies ; Stroke Volume/physiology ; Treatment Outcome ; Ventricular Function, Left/physiology
Language	English
Publishing date	2019-03-27
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2019.01.088
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