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26 results on '"Schettle, Sarah D."'

4. Inhibition of angiogenesis in the management of refractory gastrointestinal bleeding in patients with LVAD support.

Author

Inglis, Sara S., Asleh, Rabea, Iyer, Vivek N., Schettle, Sarah D., Spencer, Philip J., Villavicencio, Mauricio A., Rodeheffer, Richard J., Kushwaha, Sudhir S., Behfar, Atta, and Rosenbaum, Andrew N.

Subjects
BEVACIZUMAB, GASTROINTESTINAL hemorrhage, HEART assist devices, NEOVASCULARIZATION inhibitors, BLOOD transfusion, NEOVASCULARIZATION
Abstract

Background: Gastrointestinal bleeding (GIB) in patients with continuous flow left ventricular assist devices (CF‐LVADs) is often related to GI angiodysplasia (GIAD). We previously reported data on VEGF inhibition with IV bevacizumab in the treatment of LVAD‐associated GIAD bleeding, and now present follow‐up data on patients treated with IV bevacizumab and/or low‐dose oral pazopanib. Methods: All consecutive adult patients with LVAD‐associated GIB from GIAD treated with bevacizumab or pazopanib, from July 20, 2017 to June 22, 2022, were included in the analysis. Data on hospitalizations, GI endoscopic procedures, and blood transfusions were obtained from first admission for GIB up to a median of 35.7 months following treatment initiation (range 1.3–59.8 months). Results: Eleven patients (91% male, mean 69.5 ± 8.9 years) were included. Eight patients (73%) received IV bevacizumab, two patients (18%) received oral pazopanib, and one patient (9%) received bevacizumab followed by pazopanib therapy. We observed a significantly decreased number of annualized hospitalizations for GIB (median difference − 2.87, p = 0.002), blood transfusions (median difference − 20.9, p = 0.01), and endoscopies (median difference − 6.95, p = 0.007) in patients pre‐ and post‐anti‐angiogenic therapy (bevacizumab and/or pazopanib). Similarly, a significant improvement in these clinical outcomes was noted in the bevacizumab group with decreased annualized hospitalizations (median difference − 2.75, p = 0.014), blood transfusions (median difference − 24.5, p = 0.047), and number of endoscopies (median differences −6.88, p = 0.006). Conclusion: Anti‐angiogenic therapy with IV bevacizumab and/or low‐dose oral pazopanib appears to provide benefits in patients with LVAD‐associated GIB with reduced hospitalizations, blood transfusions, and need for GI endoscopic procedures. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Predictors and Clinical Outcomes of Vasoplegia in Patients Bridged to Heart Transplantation With Continuous‐Flow Left Ventricular Assist Devices

Author

Asleh, Rabea, primary, Alnsasra, Hilmi, additional, Daly, Richard C., additional, Schettle, Sarah D., additional, Briasoulis, Alexandros, additional, Taher, Riad, additional, Dunlay, Shannon M., additional, Stulak, John M., additional, Behfar, Atta, additional, Pereira, Naveen L., additional, Frantz, Robert P., additional, Edwards, Brooks S., additional, Clavell, Alfredo L., additional, and Kushwaha, Sudhir S., additional

Published
2019
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19. Diastolic Pulmonary Gradient as a Predictor of Right Ventricular Failure After Left Ventricular Assist Device Implantation

Author

Alnsasra, Hilmi, primary, Asleh, Rabea, additional, Schettle, Sarah D., additional, Pereira, Naveen L., additional, Frantz, Robert P., additional, Edwards, Brooks S., additional, Clavell, Alfredo L., additional, Maltais, Simon, additional, Daly, Richard C., additional, Stulak, John M., additional, Rosenbaum, Andrew N., additional, Behfar, Atta, additional, and Kushwaha, Sudhir S., additional

Published
2019
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21. Hemodynamic Assessment of Patients With and Without Heart Failure Symptoms Supported by a Continuous-Flow Left Ventricular Assist Device

Author

Asleh, Rabea, primary, Hasin, Tal, additional, Briasoulis, Alexandros, additional, Schettle, Sarah D., additional, Borlaug, Barry A., additional, Behfar, Atta, additional, Pereira, Naveen L., additional, Edwards, Brooks S., additional, Clavell, Alfredo L., additional, Joyce, Lyle D., additional, Maltais, Simon, additional, Stulak, John M., additional, and Kushwaha, Sudhir S., additional

Published
2018
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22. Small bowel bleeding in patients with left ventricular assist device: outcomes of conservative therapy versus balloon-assisted enteroscopy.

Author

Al-Bawardy, Badr, Schettle, Sarah D., Gorospe, Emmanuel, Wong Kee Song, Louis M., Pereira, Naveen L., Alexander, Jeffrey A., Bruining, David H., Coelho-Prabhu, Nayantara, Fidler, Jeff L., Mauermann, William J., Barbara, David W., Dierkhising, Ross, and Rajan, Elizabeth

Subjects
*GASTROINTESTINAL hemorrhage, *HEART assist devices, *ENTEROSCOPY
Abstract

Background Small bowel bleeding (SBB) accounts for 30% of gastrointestinal bleeding (GIB) episodes in patients with a left ventricular assist device (LVAD). The aim of this study was to determine the outcomes of conservative therapy (CT) compared to balloon- assisted enteroscopy (BAE) in the management of SBB in LVAD patients. Methods A retrospective review was performed of a prospectively maintained LVAD database from January 2003 to July 2015. LVAD patients with SBB were classified into a BAE group or a CT group according to whether they did or did not undergo BAE. Results Forty- two patients (22 BAE, 20 CT) with mean age 66±9.3 years (79% male) were included. The yield of BAE was 64% without reported complications. Overt re- bleeding occurred in 40% of the BAE group compared to 22% of the CT group. The BAE group had a higher mean number of GIB hospitalizations per month compared to the CT group (0.07 vs. 0.03; incidence rate ratio [IRR] 2.72, 95% CI 1.06- 6.98; P=0.04). There was no significant difference between the BAE and the CT groups in the number of packed red blood cell (pRBC) transfusions per month (0.42 vs. 0.18; IRR 2.31, 95% CI 0.88- 6.04; P=0.09) or all- cause mortality (61% in the CT group and 42% in the BAE group; P=0.90). Conclusion BAE is safe in LVAD patients and has a moderate therapeutic yield. In our cohort of patients, BAE did not appear to improve re- bleeding rate, GIB- related hospitalizations, pRBC transfusions or mortality compared to CT. However, future prospective trials with larger sample sizes are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Published
2018
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24. 641 Small Bowel Bleeding in Patients with Left Ventricular Assist Device: Outcomes of Balloon-Assist Enteroscopy versus Conservative Therapy

Author

Al-Bawardy, Badr, primary, Schettle, Sarah D., additional, Gorospe, Emmanuel C., additional, Alexander, Jeffrey A., additional, Bruining, David H., additional, Prabhu, Nayantara Coelho, additional, Wong Kee Song, Louis M., additional, Fidler, Jeff L., additional, Mauermann, William J., additional, Barbara, David, additional, Pereira, Naveen L., additional, and Rajan, Elizabeth, additional

Published
2016
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25. Role of ventricular assist therapy for patients with heart failure and restrictive physiology: Improving outcomes for a lethal disease

Author

Grupper, Avishay, primary, Park, Soon J., additional, Pereira, Naveen L., additional, Schettle, Sarah D., additional, Gerber, Yariv, additional, Topilsky, Yan, additional, Edwards, Brooks S., additional, Daly, Richard C., additional, Stulak, John M., additional, Joyce, Lyle D., additional, and Kushwaha, Sudhir S., additional

Published
2015
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