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1. Making a Difference: 5 Years of Cardiac Surgery Intersociety Alliance (CSIA)

Author

Bolman, R.M., primary, Zilla, P., additional, Beyersdorf, F., additional, Boateng, P., additional, Bavaria, J., additional, Dearani, J., additional, Pomar, J., additional, Kumar, S., additional, Chotivatanapong, T., additional, Sliwa, K., additional, Eisele, J.L., additional, Enumah, Z., additional, Podesser, B., additional, Farkas, E.A., additional, Kofidis, T., additional, Zühlke, L.J., additional, and Higgins, R., additional

Published
2024
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2. Making a difference: 5 years of Cardiac Surgery Intersociety Alliance (CSIA)

Author

Bolman, R M, primary, Zilla, P, additional, Beyersdorf, F, additional, Boateng, P, additional, Bavaria, J, additional, Dearani, J, additional, Pomar, J, additional, Kumar, S, additional, Chotivatanapong, T, additional, Sliwa, K, additional, Eisele, J L, additional, Enumah, Z, additional, Podesser, B, additional, Farkas, E A, additional, Kofidis, T, additional, Zühlke, L J, additional, and Higgins, R, additional

Published
2024
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3. Making a difference: 5 years of Cardiac Surgery Intersociety Alliance (CSIA).

Author

Bolman, R.M., Zilla, P., Beyersdorf, F., Boateng, P., Bavaria, J., Dearani, J., Pomar, J., Kumar, S., Chotivatanapong, T., Sliwa, K., Eisele, J.l., Enumah, Z., Podesser, B., Farkas, E.A., Kofidis, T., Zühlke, L.J., and Higgins, R.

Abstract

Informed by the almost unimaginable unmet need for cardiac surgery in the developing regions of the world, leading surgeons, cardiologists, editors in chief of the major cardiothoracic journals as well as representatives of medical industry and government convened in December 2017 to address this unacceptable disparity in access to care. The ensuing "Cape Town Declaration" constituted a clarion call to cardiac surgical societies to jointly advocate the strengthening of sustainable, local cardiac surgical capacity in the developing world. The Cardiac Surgery Intersociety Alliance (CSIA) was thus created, comprising The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS), the European Association for Cardio-Thoracic Surgery (EACTS) and the World Heart Federation (WHF). The guiding principle was advocacy for sustainable cardiac surgical capacity in low-income countries. Summary: Informed by the almost unimaginable unmet need for cardiac surgery in the developing regions of the world, leading surgeons, cardiologists, editors in chief of the major cardiothoracic journals as well as representatives of medical industry and government convened in December 2017 to address this unacceptable disparity in access to care. The ensuing "Cape Town Declaration" constituted a clarion call to cardiac surgical societies to jointly advocate the strengthening of sustainable, local cardiac surgical capacity in the developing world. The Cardiac Surgery Intersociety Alliance (CSIA) was thus created, comprising The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS), the European Association for Cardio-Thoracic Surgery (EACTS) and the World Heart Federation (WHF). The guiding principle was advocacy for sustainable cardiac surgical capacity in low-income countries. As a first step, a global needs assessment confirmed rheumatic heart disease as the overwhelming pathology requiring cardiac surgery in these regions. Subsequently, CSIA published a request for proposals to support fledgling programmes that could demonstrate the backing by their governments and health care institution. Out of 11 applicants, and following an evaluation of the sites, including site visits to the 3 finalists, Mozambique and Rwanda were selected as the first Pilot Sites. Subsequently, a mentorship and training agreement was completed between Mozambique and the University of Cape Town, a middle-income country with a comparable burden of rheumatic heart disease. The agreement entails regular video calls between the heart teams, targeted training across all aspects of cardiac surgery, as well as on-site presence of mentoring teams for complex cases with the strict observance of 'assisting only'. In Rwanda, Team Heart, a US and Rwanda-based non-governmental organization (NGO) that has been performing cardiac surgery in Rwanda and helping to train the cardiac surgery workforce since 2008, has agreed to continue providing mentorship for the local team and to assist in the establishment of independent cardiac surgery with all that entails. This involves intermittent virtual conferences between Rwandan and US cardiologists for surgical case selection. Five years after CSIA was founded, it's 'Seal of Approval' for the sustainability of endorsed programmes in Mozambique and Rwanda has resulted in higher case numbers, a stronger government commitment, significant upgrades of infrastructure, the nurturing of generous consumable donations by industry and the commencement of negotiations with global donors for major grants. Extending the CSIA Seal to additional deserving programmes could further align the international cardiac surgical community with the principle of local cardiac surgery capacity-building in developing countries. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Practice of neuromonitoring in open and endovascular thoracoabdominal aortic repair-an international expert-based modified Delphi consensus study

Author

Schachner, T., Gottardi, R., Schmidli, J., Wyss, T.R., Berg, J.C. Van Den, Tsilimparis, N., Bavaria, J., Bertoglio, L., Heijmen, R.H., Martens, A., Czerny, M., Schachner, T., Gottardi, R., Schmidli, J., Wyss, T.R., Berg, J.C. Van Den, Tsilimparis, N., Bavaria, J., Bertoglio, L., Heijmen, R.H., Martens, A., and Czerny, M.

Abstract

Item does not contain fulltext, OBJECTIVES: Spinal cord injury is detrimental for patients undergoing open or endovascular thoracoabdominal aortic aneurysm (TAAA) repair. The aim of this survey and of the modified Delphi consensus was to gather information on current practices and standards in neuroprotection in patients undergoing open and endovascular TAAA. METHODS: The Aortic Association conducted an international online survey on neuromonitoring in open and endovascular TAAA repair. In a first round an expert panel put together a survey on different aspects of neuromonitoring. Based on the answers from the first round of the survey, 18 Delphi consensus questions were formulated. RESULTS: A total of 56 physicians completed the survey. Of these, 45 perform open and endovascular TAAA repair, 3 do open TAAA repair and 8 do endovascular TAAA repair. At least 1 neuromonitoring or protection modality is utilized during open TAAA surgery. Cerebrospinal fluid (CSF) drainage was used in 97.9%, near infrared spectroscopy in 70.8% and motor evoked potentials or somatosensory evoked potentials in 60.4%. Three of 53 centres do not utilize any form of neuromonitoring or protection during endovascular TAAA repair: 92.5% use CSF drainage; 35.8%, cerebral or paravertebral near infrared spectroscopy; and 24.5% motor evoked potentials or somatosensory evoked potentials. The utilization of CSF drainage and neuromonitoring varies depending on the extent of the TAAA repair. CONCLUSIONS: The results of this survey and of the Delphi consensus show that there is broad consensus on the importance of protecting the spinal cord to avoid spinal cord injury in patients undergoing open TAAA repair. Those measures are less frequently utilized in patients undergoing endovascular TAAA repair but should be considered, especially in patients who require extensive coverage of the thoracoabdominal aorta.

Published
2023

6. International consensus statement on nomenclature and classification of the congenital bicuspid aortic valve and its aortopathy, for clinical, surgical, interventional and research purposes

Author

Michelena, H.I., Corte, A. della, Evangelista, A., Maleszewski, J.J., Edwards, W.D., Roman, M.J., Devereux, R.B., Fernandez, B., Asch, F.M., Barker, A.J., Sierra-Galan, L.M., Kerchove, L. de, Fernandes, S.M., Fedak, P.W.M., Girdauskas, E., Delgado, V., Abbara, S., Lansac, E., Prakash, S.K., Bissell, M.M., Popescu, B.A., Hope, M.D., Sitges, M., Thourani, V.H., Pibarot, P., Chandrasekaran, K., Lancellotti, P., Borger, M.A., Forrest, J.K., Webb, J., Milewicz, D.M., Makkar, R., Leon, M.B., Sanders, S.P., Markl, M., Ferrari, V.A., Roberts, W.C., Song, J.K., Blanke, P., White, C.S., Siu, S., Svensson, L.G., Braverman, A.C., Bavaria, J., Sundt, T.M., Khoury, G. el, Paulis, R. de, Enriquez-Sarano, M., Bax, J.J., Otto, C.M., Schafers, H.J., Endorsed Heart Valve Soc HVS, European Assoc Cardiovasc Imaging, Soc Thoracic Surg STS, Amer Assoc Thoracic Surg AATS, Soc Cardiovasc Magnetic Resonance, Soc Cardiovasc Computed Tomography, North Amer Soc Cardiovasc Imaging, Int Bicuspid Aortic Valve Consorti, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, Michelena, H. I., Della Corte, A., Evangelista, A., Maleszewski, J. J., Edwards, W. D., Roman, M. J., Devereux, R. B., Fernandez, B., Asch, F. M., Barker, A. J., Sierra-Galan, L. M., De Kerchove, L., Fernandes, S. M., Fedak, P. W. M., Girdauskas, E., Delgado, V., Abbara, S., Lansac, E., Prakash, S. K., Bissell, M. M., Popescu, B. A., Hope, M. D., Sitges, M., Thourani, V. H., Pibarot, P., Chandrasekaran, K., Lancellotti, P., Borger, M. A., Forrest, J. K., Webb, J., Milewicz, D. M., Makkar, R., Leon, M. B., Sanders, S. P., Markl, M., Ferrari, V. A., Roberts, W. C., Song, J. -K., Blanke, P., White, C. S., Siu, S., Svensson, L. G., Braverman, A. C., Bavaria, J., Sundt, T. M., El Khoury, G., De Paulis, R., Enriquez-Sarano, M., Bax, J. J., Otto, C. M., Schafers, H. -J., Michelena, Hector I, Corte, Alessandro Della, Evangelista, Arturo, Maleszewski, Joseph J, Edwards, William D, Roman, Mary J, Devereux, Richard B, Fernández, Borja, Asch, Federico M, Barker, Alex J, Sierra-Galan, Lilia M, De Kerchove, Laurent, Fernandes, Susan M, Fedak, Paul W M, Girdauskas, Evalda, Delgado, Victoria, Abbara, Suhny, Lansac, Emmanuel, Prakash, Siddharth K, Bissell, Malenka M, Popescu, Bogdan A, Hope, Michael D, Sitges, Marta, Thourani, Vinod H, Pibarot, Phillippe, Chandrasekaran, Krishnaswamy, Lancellotti, Patrizio, Borger, Michael A, Forrest, John K, Webb, John, Milewicz, Dianna M, Makkaar, Raj, Leon, Martin B, Sanders, Stephen P, Markl, Michael, Ferrari, Victor A, Roberts, William C, Song, Jae-Kwan, Blanke, Philipp, White, Charles S, Siu, Samuel, Svensson, Lars G, Braverman, Alan C, Bavaria, Joseph, Sundt, Thoralf M, El Khoury, Gebrine, De Paulis, Ruggero, Enriquez-Sarano, Maurice, Bax, Jeroen J, Otto, Catherine M, and Schäfers, Hans-Joachim

Subjects
Statement (logic), Predictive Value of Test, Computed tomography, 030204 cardiovascular system & hematology, Congenital Aortic Valve Insufficiency, 0302 clinical medicine, Bicuspid aortic valve, Bicuspid Aortic Valve Disease, 030212 general & internal medicine, Nomenclature, Aorta, medicine.diagnostic_test, General Medicine, Anatomy, Prognosis, Classification, Phenotype, Aortic Valve, cardiovascular system, Cardiology and Cardiovascular Medicine, Key Words, Human, Pulmonary and Respiratory Medicine, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Consensus, Prognosi, education, Aortic Diseases, Consensu, Aortography, 03 medical and health sciences, Bicuspid valve, Predictive Value of Tests, Terminology as Topic, Aortopathy, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Special Report, Cardiac Imaging Technique, business.industry, General surgery, Systematized Nomenclature of Medicine, Forme fruste, nomencla-ture, Aortic Valve Stenosis, Aortic Disease, medicine.disease, Aortic Valve Stenosi, Cardiac Imaging Techniques, Cusp (anatomy), Surgery, business
Abstract

This International Consensus Classification and Nomenclature for the congenital bicuspid aortic valve condition recognizes 3 types of bicuspid valves: 1. The fused type (right-left cusp fusion, right-non-coronary cusp fusion and left-non-coronary cusp fusion phenotypes); 2. The 2-sinus type (latero-lateral and antero-posterior phenotypes); and 3. The partial-fusion (forme fruste) type. The presence of raphe and the symmetry of the fused type phenotypes are critical aspects to describe. The International Consensus also recognizes 3 types of bicuspid valve-associated aortopathy: 1. The ascending phenotype; 2. The root phenotype; and 3. Extended phenotypes. © 2021 Jointly between the RSNA, the European Association for Cardio-Thoracic Surgery, The Society of Thoracic Surgeons, and the American Association for Thoracic Surgery. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. All rights reserved. Keywords: Bicuspid Aortic Valve, Aortopathy, Nomenclature, Classification.

Published
2021

7. Surgical Explantation After TAVR Failure: Mid-Term Outcomes From the EXPLANT-TAVR International Registry

Author

Bapat, V. N., Zaid, S., Fukuhara, S., Saha, S., Vitanova, K., Kiefer, P., Squiers, J. J., Voisine, P., Pirelli, L., von Ballmoos, M. W., Chu, M. W. A., Rodes-Cabau, J., Dimaio, J. M., Borger, M. A., Lange, R., Hagl, C., Denti, P., Modine, T., Kaneko, T., Tang, G. H. L., Sengupta, A., Holzhey, D., Noack, T., Harrington, K. B., Mohammadi, S., Brinster, D. R., Atkins, M. D., Algadheeb, M., Bagur, R., Desai, N. D., Bhadra, O. D., Conradi, L., Shults, C., Satler, L. F., Ramlawi, B., Robinson, N. B., Wang, L., Petrossian, G. A., Andreas, M., Werner, P., Garatti, A., Vincent, F., Van Belle, E., Juthier, F., Leroux, L., Doty, J. R., Goldberg, J. B., Ahmad, H. A., Goel, K., Shah, A. S., Geirsson, A., Forrest, J. K., Grubb, K. J., Hirji, S., Shah, P. B., Bruschi, G., Gelpi, G., Belluschi, I., Ouzounian, M., Ruel, M., Al-Atassi, T., Kempfert, J., Unbehaun, A., Van Mieghem, N. M., Hokken, T. W., Ben Ali, W., Ibrahim, R., Demers, P., Pizano, A., Di Eusanio, M., Capestro, F., Estevez-Loureiro, R., Pinon, M. A., Salinger, M. H., Rovin, J., D'Onofrio, A., Tessari, C., Di Virgilio, A., Taramasso, M., Gennari, M., Colli, A., Whisenant, B. K., Nazif, T. M., Kleiman, N. S., Szerlip, M. Y., Waksman, R., George, I., Nguyen, T. C., Maisano, F., Deeb, G. M., Bavaria, J. E., Reardon, M. J., Mack, M. J., Brinkman, W. T., George, T. J., Potluri, S., Ryan, W. H., Schaffer, J. M., Smith, R. L., Szerlip, M., Nazif, T., Rahim, H., Grubb, K., Atkins, M., Goel, S., Kleiman, N., Reardon, M., Doty, J., Whisenant, B., Salinger, M., Satler, L., Schults, C., Fisher, S., Alexis, S. L., Kliger, C. A., Rutkin, B., P. -J., Yu, Petrossian, G., Robinson, N., Deeb, M., Oakley, J., Bavaria, J., Desai, N., Walsh, L., Nguyen, T., Ahmad, H., Goldberg, J., Spielvogel, D., Forrest, J., Chu, M., Cartier, R., Abois, A. -P., Boodhwani, M., Dick, A., Glover, C., Labinaz, M., Lam, B. -K., Delhaye, C., Delsaux, A., Denimal, T., Gaul, A., Koussa, M., Pamart, T., Sonnabend, S., Krane, M., Munsterer, A., Bhadra, O., Merlanti, B., Russo, C. F., Romagnoni, C., and Pinnon, M.

Subjects
TAVR explantation, TAVR failure, surgical aortic valve replacement, transcatheter aortic valve replacement
Published
2021

8. P5608Acute respiratory failure after type A aortic dissection repair: data from the International Registry of Aortic Dissection (IRAD)

Author

Ballotta, A B, primary, Kandil, H, additional, Montgomery, D G, additional, Ranucci, M, additional, Trimarchi, S, additional, Myrmel, T, additional, Bavaria, J E, additional, Sundt, T M, additional, Bossone, E, additional, Suzuki, T, additional, Ota, T, additional, Nienaber, C A, additional, Isselbacher, E M, additional, Eagle, K A, additional, and Patel, H J, additional

Published
2019
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10. P6030Association of renin-angiotensin system inhibition with clinical outcomes in patients undergoing transcatheter aortic valve replacement: analysis from the STS/ACC TVT Registry

Author

Inohara, T, primary, Manandhar, P, additional, Kosinski, A, additional, Kohsaka, S, additional, Mentz, R J, additional, Thourani, V H, additional, Carroll, J D, additional, Kirtane, A J, additional, Bavaria, J E, additional, Cohen, D J, additional, Kiefer, T L, additional, Gaca, J G, additional, Kapadia, S R, additional, and Vemulapalli, S, additional

Published
2018
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12. Comparison of Transesophageal Echocardiographic Analysis and Circulating Biomarker Expression Profile in Calcific Aortic Valve Disease

Author

Sainger, R., Grau, J. B., Branchetti, E., Paolo Poggio, Lai, E., Koka, E., Vernick, W. J., Gorman, R. C., Bavaria, J. E., and Ferrari, G.

Subjects
Aged, 80 and over, Male, Sclerosis, alpha-2-HS-Glycoprotein, Calcinosis, Aortic Valve Stenosis, Arginine, Severity of Illness Index, Article, Peptide Fragments, Parathyroid Hormone, Aortic Valve, Case-Control Studies, Natriuretic Peptide, Brain, Humans, Female, Osteopontin, Biomarkers, Echocardiography, Transesophageal, Aged
Abstract

Aortic valve sclerosis (AVSc), the early asymptomatic stage of calcific aortic valve disease (CAVD), is characterized by a progressive thickening of the aortic cusps without obstruction of the left ventricular outflow. In spite of its high prevalence, there are no molecular markers to characterize the early stages of CAVD before it progresses to a severe, symptomatic stage of aortic valve stenosis (AVS). The study aim was to identify any correlation between circulating biomarkers and transesophageal echocardiography (TEE) evaluation.A total of 330 patients with various degrees of CAVD was enrolled into the study. Blood was collected from each patient prior to surgery, and analyzed using ELISA kits following the manufacturers' instructions.Significantly higher plasma osteopontin (OPN) levels were observed in AVSc patients (72.7 +/- 1.8 ng/ml; p0.001) and AVS patients (64.3 +/- 5.1 ng/ml; p0.001) when compared to controls (30.3 +/- 1.8 ng/ml). Parathyroid hormone (PTH) levels in AVSc and AVS patients (164.1 +/- 16.5 and 134.3 +/- 14.6 pg/ml; p0.001 and p = 0.04, respectively) were also significantly higher than in controls (61.8 +/- 4.92 pg/ml). Upon further analysis, plasma levels of OPN (p0.001) and PTH (p0.001) were found to be significantly higher in asymptomatic AVSc patients, even before calcium deposition was detected on TEE evaluation. Fetuin-A levels were lower at all stages of CAVD when compared to controls (p0.001 and por = 0.05, respectively), but were comparable among the patient groups. NT-proBNP levels were significantly higher in AVS patients than in controls (por = 0.01).Serum levels of OPN, PTH, and fetuin-A showed a significant association with different stages of CAVD, with variations in their levels occurring before calcium nodules are visualized during TEE evaluation. The study results may help not only to provide a better understanding of the progression of CAVD but also to develop new tools that can be used to stage these patients.

Published
2013

19. The ARCH Projects: design and rationale (IAASSG 001)

Author

Yan, T. D., primary, Tian, D. H., additional, LeMaire, S. A., additional, Misfeld, M., additional, Elefteriades, J. A., additional, Chen, E. P., additional, Chad Hughes, G., additional, Kazui, T., additional, Griepp, R. B., additional, Kouchoukos, N. T., additional, Bannon, P. G., additional, Underwood, M. J., additional, Mohr, F.-W., additional, Oo, A., additional, Sundt, T. M., additional, Bavaria, J. E., additional, Di Bartolomeo, R., additional, Di Eusanio, M., additional, Roselli, E. E., additional, Beyersdorf, F., additional, Carrel, T. P., additional, Corvera, J. S., additional, Della Corte, A., additional, Ehrlich, M., additional, Hoffman, A., additional, Jakob, H., additional, Matalanis, G., additional, Numata, S., additional, Patel, H. J., additional, Pochettino, A., additional, Safi, H. J., additional, Estrera, A., additional, Perreas, K. G., additional, Sinatra, R., additional, Trimarchi, S., additional, Sun, L.-Z., additional, Tabata, M., additional, Wang, C., additional, Haverich, A., additional, Shrestha, M., additional, Okita, Y., additional, and Coselli, J., additional

Published
2013
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27. The future of aortic surgery in Europe

Author

Czerny, M., primary, Bachet, J., additional, Bavaria, J., additional, Bonser, R. S., additional, Borger, M. A., additional, De Paulis, R., additional, DiBartolomeo, R., additional, Grabenwoger, M., additional, Lonn, L., additional, Loubani, M., additional, Mestres, C. A., additional, Schepens, M. A. A. M., additional, Weigang, E., additional, and Carrel, T. P., additional

Published
2012
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41. Fatal hyperammonemia after orthotopic lung transplantation.

Author

Lichtenstein, Gary R., Nunes, Frederick A., Lichtenstein, G R, Yang, Y X, Nunes, F A, Lewis, J D, Tuchman, M, Tino, G, Kaiser, L R, Palevsky, H I, Kotloff, R M, Furth, E E, Bavaria, J E, Stecker, M M, Kaplan, P, and Berry, G T

Subjects
LUNG transplantation, AMMONIUM, PHYSIOLOGY
Abstract

Background: A case of fatal hyperammonemia complicating orthotopic lung transplantation was previously reported.Objective: To describe the incidence, clinical features, and treatment of hyperammonemia associated with orthotopic lung transplantation.Design: Retrospective cohort analysis.Setting: Academic medical center and lung transplantation center in Philadelphia, Pennsylvania.Patients: 145 sequential adult patients who underwent orthotopic lung transplantation.Measurements: Plasma ammonium levels.Results: Six of the 145 patients who had had orthotopic lung transplantation developed hyperammonemia, all within the first 26 days after transplantation. The 30-day post-transplantation mortality rate was 67% for patients with hyperammonemia compared with 17% for those without hyperammonemia (P = 0.01). Development of major gastrointestinal complications (P = 0.03), use of total parenteral nutrition (P < 0.001), and lung transplantation for primary pulmonary hypertension (P = 0.045) were associated with hyperammonemia.Conclusions: Hyperammonemia is a potentially fatal event occurring after orthotopic lung transplantation. It is associated with high nitrogen load, concurrent medical stressors, primary pulmonary hypertension, and hepatic glutamine synthetase deficiency. [ABSTRACT FROM AUTHOR]

Published
2000
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42. Giant gastric ulcers and risk factors for gastroduodenal mucosal disease in orthotopic lung transplant patients.

Author

Lipson, David, Berlin, Jesse, Palevsky, Harold, Kotloff, Robert, Tino, Gregory, Bavaria, Joseph, Kaiser, Larry, Long, William, Metz, David, Lichtenstein, Gary, Lipson, D A, Berlin, J A, Palevsky, H I, Kotloff, R M, Tino, G, Bavaria, J, Kaiser, L, Long, W B, Metz, D C, and Lichtenstein, G R

Abstract

Giant gastric ulcers are defined as ulcers with a diameter greater than 3 cm. Previously they have not been described in lung transplant recipients. We report a high incidence of symptomatic giant gastric ulcers and identify the risk factors for ulcer development in these patients. We examined the records of all 95 patients who had undergone lung transplantation at our institution from November 1991 to July 1995. Fourteen of the patients who underwent lung transplantation developed symptoms that required esophagogastroduodenoscopy. Three of these patients (21%) were found to have giant gastric ulcers. The relative risk of giant gastric ulcer in symptomatic patients undergoing endoscopy after lung transplantation is over 40 times that of population controls. The patients who developed giant gastric ulcers, despite H2 antagonist use, had all received bilateral lung transplantation and had received nonsteroidal antiinflammatory drugs, cyclosporine, and high-dose intravenous corticosteroids. The risk of developing giant gastric ulcers is significantly increased in patients who have undergone bilateral orthotopic lung transplantation. Clinicians should be made aware of this complication in order to avoid use of ulcerogenic medications in this population. Avoidance of these medications could potentially minimize the risk of this complication. [ABSTRACT FROM AUTHOR]

Published
1998
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46. Risk analysis for thoracoscopic lung volume reduction: a multi-institutional experience.

Author

Naunheim, K S, Hazelrigg, S R, Kaiser, L R, Keenan, R J, Bavaria, J E, Landreneau, R J, Osterloh, J, and Keller, C A

Abstract

Most reports of thoracoscopic lung volume reduction (TLVR) are relatively small and early experiences from a single institution, factors which limit both the statistical validity and the applicability to the population at large. In order to address these shortcomings we undertook an analysis of the TLVR experience at five separate institutions to assess operative morbidity and identify predictors of mortality.

Published
2000
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48. Analysis of Epstein-Barr virus-associated posttransplantation lymphoproliferative disorder after lung transplantation

Author

Montone, K.T., Litzky, L.A., Wurster, A., Kaiser, L., Bavaria, J., Kotloff, R., Palevsky, H., Pietra, G.G., and Tomaszewski, J.E.

Abstract

Background. Epstein-Barr virus (EBV)-associated posttransplantation lymphoproliferative disorder (PTLD) is a serious complication of lung transplantation. Besides immunosuppression the risk factors for PTLD development are largely unknown. Methods. The incidence of PTLD was ascertained in a lung transplant population consisting of 45 patients. Nine patients (20%) experienced PTLD. The clinical, histologic, and human leukocyte antigen (HLA) data were collected on all patients. The incidence of EBV infection in lymphoid tissue taken at the time of engraftment was studied by using EBV in situ hybridization. Results. All patients with PTLD had polymorphous lymphoproliferations, seven of which were polymorphous B-cell hyperplasias and two of which were polymorphous B-cell lymphomas. EBV was identified in all lesions. All patients with polymorphous B-cell hyperplasias had clinically unsuspected disease, five of which were identified at autopsy. The two polymorphous B-cell lymphoma lesions were monoclonal and regressed with immunosuppression reduction. EBV in situ hybridization on donor or recipient lymph nodes obtained at engraftment from the 45 transplant recipients showed no difference in the number of EBV positive cells in patients with and without PTLD. Cyclosporine and azathioprine dosages and cyclosporine levels were similar between patients with and without PTLD. PTLD was seen in patients with high cumulative doses of antilymphocyte globulin. Analysis of HLA status showed a predominance of HLA A2 and DR7 in the donors of the patients with PTLD, whereas donor HLA B7 was more common in patients without PTLD. Conclusions. Detailed studies are necessary to further elucidate the risk factors for PTLD development in the lung transplant population.

Published
1996
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