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93


Longitudinal Echocardiographic Assessment of Donor Hearts in DCD Donors Using Thoracoabdominal Normothermic Regional Perfusion [Meeting Abstract]

Gidea, C. G.; James, L.; Smith, D.; Carillo, J.; Reyentovich, A.; Saraon, T.; Goldberg, R.; Kadosh, B.; Ngai, J.; Piper, G.; Moazami, N.
ISI:000780119700099
ISSN: 1053-2498
CID: 5243522

Interleukin-2 Receptor Antagonists Induction Therapy in Simultaneous Heart - Kidney Transplantation [Meeting Abstract]

Samra, A.; Gidea, C.; Malik, T.; Sikand, N.; Montgomery, R.; Lonze, B.; Reyentovich, A.; Saraon, T.; Soomro, I.; Goldberg, R.; Tatapudi, V.; Ali, N.; Moazami, N.; Mattoo, A.
ISI:000780119700473
ISSN: 1053-2498
CID: 5243532

Transplant Outcomes in Hearts with Moderate to Severe Left Ventricular Hypertrophy After the 2018 OPTN/UNOS Allocation Changes [Meeting Abstract]

Ramachandran, A.; Siddiqui, E.; Reyentovich, A.; Lonze, B.; Saraon, T.; Rao, S.; Katz, S.; Goldberg, R.; Kadosh, B.; DiVita, M.; Cruz, J.; Carillo, J.; Smith, D.; Moazami, N.; Gidea., C.
ISI:000780119700501
ISSN: 1053-2498
CID: 5243542

Primary Graft Dysfunction After Heart Transplantation: Incidence and Current Risk Factors [Meeting Abstract]

Chen, S.; Ostberg, N. P.; Carillo, J. A.; Gidea, C.; Reyentovich, A.; Galloway, A. C.; Moazami, N.; Smith, D. E.
ISI:000780119701158
ISSN: 1053-2498
CID: 5243552

Defining the Normal Values for Left Ventricular Global Longitudinal Strain in Adult Heart Transplanted Patients [Meeting Abstract]

Sikand, N. V.; Maidman, S.; Saric, M.; Reyentovich, A.; Saraon, T.; Rao, S.; Katz, S.; Goldberg, R.; Kadosh, B.; DiVita, M.; Cruz, J.; Riggio, S.; Moazami, N.; Gidea, C.
ISI:000780119701376
ISSN: 1053-2498
CID: 5243562

Syndrome of Reversible Cardiogenic Shock and Left Ventricular Ballooning in Obstructive Hypertrophic Cardiomyopathy

Sherrid, Mark V; Swistel, Daniel G; Olivotto, Iacopo; Pieroni, Maurizio; Wever-Pinzon, Omar; Riedy, Katherine; Bach, Richard G; Husaini, Mustafa; Cresci, Sharon; Reyentovich, Alex; Massera, Daniele; Maron, Martin S; Maron, Barry J; Kim, Bette
Background Cardiogenic shock from most causes has unfavorable prognosis. Hypertrophic cardiomyopathy (HCM) can uncommonly present with apical ballooning and shock in association with sudden development of severe and unrelenting left ventricular (LV) outflow obstruction. Typical HCM phenotypic features of mild septal thickening, outflow gradients, and distinctive mitral abnormalities differentiate these patients from others with Takotsubo syndrome, who have normal mitral valves and no outflow obstruction. Methods and Results We analyzed 8 patients from our 4 HCM centers with obstructive HCM and abrupt presentation of cardiogenic shock with LV ballooning, and 6 cases reported in literature. Of 14 patients, 10 (71%) were women, aged 66±9 years, presenting with acute symptoms: LV ballooning; depressed ejection fraction (25±5%); refractory systemic hypotension; marked LV outflow tract obstruction (peak gradient, 94±28 mm Hg); and elevated troponin, but absence of atherosclerotic coronary disease. Shock was managed with intravenous administration of phenylephrine (n=6), norepinephrine (n=6), β-blocker (n=7), and vasopressin (n=1). Mechanical circulatory support was required in 8, including intra-aortic balloon pump (n=4), venoarterial extracorporeal membrane oxygenation (n=3), and Impella and Tandem Heart in 1 each. In refractory shock, urgent relief of obstruction by myectomy was performed in 5, and alcohol ablation in 1. All patients survived their critical illness, with full recovery of systolic function. Conclusions When cardiogenic shock and LV ballooning occur in obstructive HCM, they are marked by distinctive anatomic and physiologic features. Relief of obstruction with targeted pharmacotherapy, mechanical circulatory support, and myectomy, when necessary for refractory shock, may lead to survival and normalization of systolic function.
PMID: 34634917
ISSN: 2047-9980
CID: 5061922

Clinical and Financial Implications of 2 Treatment Strategies for Donor-derived Hepatitis C Infections

Stewart, Zoe A; Stern, Jeffrey; Ali, Nicole M; Kalia, Harmit S; Khalil, Karen; Jonchhe, Srijana; Weldon, Elaina P; Dieter, Rebecca A; Lewis, Tyler C; Funches, Nur; Crosby, Sudara; Seow, Monique; Berger, Jonathan C; Dagher, Nabil N; Gelb, Bruce E; Watkins, Anthony C; Moazami, Nader; Smith, Deane E; Kon, Zachary N; Chang, Stephanie H; Reyentovich, Alex; Angel, Luis F; Montgomery, Robert A; Lonze, Bonnie E
Transplanting hepatitis C viremic donor organs into hepatitis C virus (HCV)-negative recipients is becoming increasingly common; however, practices for posttransplant direct-acting antiviral (DAA) treatment vary widely. Protracted insurance authorization processes for DAA therapy often lead to treatment delays.
PMCID:8425828
PMID: 34514117
ISSN: 2373-8731
CID: 5067212

Comparison of Outcomes of Enoxaparin Bridge Therapy in HeartMate II versus HeartWare HVAD Recipients

Patel, Mitulkumar; Ahuja, Tania; Arnouk, Serena; Gidea, Claudia; Reyentovich, Alex; Smith, Deane E; Moazami, Nader; Papadopoulos, John; Lewis, Tyler C
BACKGROUND/UNASSIGNED:There is a lack of robust data evaluating outcomes of enoxaparin "bridge" therapy in left ventricular assist device (LVAD) patients. METHODS/UNASSIGNED:We performed a retrospective study of HeartMate II (HM II) and HeartWare HVAD recipients that received therapeutic enoxaparin as "bridge" therapy to describe bleeding and thrombotic events and compare outcomes between devices. The primary endpoint was the incidence of bleeding within 30 days of "bridge" episode. Major bleeding was defined by INTERMACS criteria. RESULTS/UNASSIGNED:= .02). We observed 3 (1%) thromboembolic events in 2 (4%) patients with an HVAD device. On multivariate analysis, the presence of a HM II device was associated with a 4-fold increased risk of bleeding. CONCLUSION/UNASSIGNED:We found the use of enoxaparin "bridge" therapy to be associated with a higher incidence of bleeding in patients with a HM II device compared with an HVAD device. Assessment of device- and patient-specific factors should be evaluated to minimize bleeding events.
PMID: 33844604
ISSN: 1940-4034
CID: 4845762

COVID-19 Impact on Heart Organ Transplantation - New Insights from a Single-Center Experience [Meeting Abstract]

Gidea, C G; Moazami, N; Neumann, H; Fargnoli, A; Pavone, J; Lewis, T; Saraon, T; Goldberg, R; Kadosh, B; Katz, S; Rao, S; Metha, S; Smith, D; Reyentovich, A
Purpose: During the COVID 19- pandemic, there is no consensus on management strategies for treating infected heart transplant patients. The outcomes of these patients vary by institution. We report our center experience and management strategies to date.
Method(s): All patients who received heart transplantation, from January 4th 2018 to September 25th 2020 and were diagnosed with SARS-CoV-2 were included and full chart review was performed.
Result(s): There were 113 heart transplants at our institution by September 2020. A total of 13 (12%) patients were infected with SARS-CoV-2: 9 (69%) isolated heart, 3 heart -kidney (23%) and 1 heat- lung (8%). The median (IQR) time from transplant to diagnosis was 10 (5-16) months. The mean age was 57 years and 50% were male; 50% were of Hispanic ethnicity. The main presenting symptoms were fever (43%), cough (86%) and SOB (43%). Chest x-ray was abnormal in all patients. We evaluated all patients and 79% were hospitalized and 21% were closely monitored as outpatients. None of our patients were hospitalized at outside institutions. Two (14%) required intubation and none required V-V ECMO support. The immunotherapy was modified in all patients: MMF and prednisone were discontinued, tacrolimus dose was reduced. COVID19 treatment was: 71% received hydroxychloroquine, 50% azithromycin, 15% remdesevir, 7% convalescent plasma. All hospitalized patients received anticoagulation. One patient had 2R/3A rejection within 30 days prior to diagnosis. Graft function was maintained in all patients with median LVEF% 65 (59-65%) except one patient who had received thymoglobulin 2 weeks prior to COVID 19 infection (LVEF 30%). The patient had a prolonged intubation but ultimately recovered and was discharged from the hospital. The one death (7.1%) was a heart - kidney recipient who concomitantly presented with pseudomonas sepsis and severe neutropenia. The remaining patients have all been discharged home.
Conclusion(s): We present our single center experience in managing COVID 19 infected heart transplant patients. We implemented uniform management strategies by incorporating aggressive reduction of immunosuppression, frequent scheduled contacts with infected outpatients and making sure all infected patients requiring hospitalization were treated at a transplant center.
Copyright
EMBASE:2011433496
ISSN: 1557-3117
CID: 5138672

A novel protocol to reduce bleeding associated with alteplase treatment of HVAD pump thrombosis

Lewis, Tyler C; Emmarco, Amy; Gidea, Claudia G; Reyentovich, Alex; Smith, Deane E; Moazami, Nader
Pump thrombosis remains a feared complication for patients implanted with durable left ventricular assist devices. Optimal treatment is unknown, but consists of either pharmacologic fibrinolysis or surgical pump exchange. Fibrinolysis is less invasive, but carries a significant risk of intracerebral hemorrhage. We present four cases of LVAD pump thrombosis successfully treated with a novel protocol that consists of low-dose four-factor prothrombin complex concentrate to reverse baseline INR elevation prior to alteplase administration to minimize the risk for intracerebral hemorrhage.
PMID: 33596706
ISSN: 1724-6040
CID: 4786892