Edelman JJ, Thourani VH

Edelman JJ, Thourani VH

J. Thorac. Cardiovasc. Surg. 2018 Oct;

PMID: 30454979

Abstract

Edelman JJ, Thourani VH

J. Thorac. Cardiovasc. Surg. 2018 Dec;156(6):2135-2137

PMID: 30449571

Abstract

Austin DE, Burns B, Lowe D, Cartwright B, Clarke A, Dennis M, D’Souza M, Nathan R, Bannon PG, Gattas D, Connellan M, Forrest P

Anaesth Intensive Care 2018 Nov;46(6):579-588

PMID: 30447667

Abstract

In New South Wales, a coordinated extracorporeal membrane oxygenation (ECMO) retrieval program has been in operation since 2007. This study describes the characteristics and outcomes of patients transported by this service. We performed a retrospective observational study and included patients who were transported on ECMO to either of two adult tertiary referral hospitals in Sydney, New South Wales, between February 28, 2007 and February 29, 2016. One hundred and sixty-four ECMO-facilitated transports occurred, involving 160 patients. Of these, 118 patients (74%) were treated with veno-venous (VV) ECMO and 42 patients (26%) were treated with veno-arterial ECMO. The mean (standard deviation, SD) age was 40.4 (15.0) years. Seventy-seven transports (47%) occurred within metropolitan Sydney, 52 (32%) were from rural or regional areas within NSW, 17 (10%) were interstate transfers and 18 (11%) were international transfers. Transfers were by road (58%), fixed wing aircraft (27%) or helicopter (15%). No deaths occurred during transport. The median (interquartile range) duration of ECMO treatment was 8.9 (5.2-15.3) days. One hundred and nineteen patients (74%) were successfully weaned from ECMO and 109 (68%) survived to hospital discharge or transfer. In patients treated with VV ECMO, age, sequential organ failure assessment score, pre-existing immunosuppressive disease, pre-existing diabetes, renal failure requiring dialysis and failed prone positioning prior to ECMO were independently associated with increased mortality. ECMO-facilitated patient transport is feasible, safe, and results in acceptable short-term outcomes. The NSW ECMO Retrieval Service provides specialised support to patients with severe respiratory and cardiovascular illness, who may otherwise be too unstable to undergo inter-hospital transfer to access advanced cardiovascular and critical care services.

Edelman JJ, Khan JM, Thourani VH

J. Thorac. Cardiovasc. Surg. 2018 Oct;

PMID: 30414768

Abstract

Clayton ZE, Tan RP, Miravet MM, Lennartsson K, Cooke JP, Bursill CA, Wise SG, Patel S

Biosci. Rep. 2018 08;38(4)

PMID: 29976773

Abstract

Chronic wounds are a major complication in patients with cardiovascular diseases. Cell therapies have shown potential to stimulate wound healing, but clinical trials using adult stem cells have been tempered by limited numbers of cells and invasive procurement procedures. Induced pluripotent stem cells (iPSCs) have several advantages of other cell types, for example they can be generated in abundance from patients’ somatic cells (autologous) or those from a matched donor. iPSCs can be efficiently differentiated to functional endothelial cells (iPSC-ECs). Here, we used a murine excisional wound model to test the pro-angiogenic properties of iPSC-ECs in wound healing. Two full-thickness wounds were made on the dorsum of NOD-SCID mice and splinted. iPSC-ECs (5 × 10) were topically applied to one wound, with the other serving as a control. Treatment with iPSC-ECs significantly increased wound perfusion and accelerated wound closure. Expression of endothelial cell (EC) surface marker, platelet endothelial cell adhesion molecule (PECAM-1) (CD31), and pro-angiogenic EC receptor, Tie1, mRNA was up-regulated in iPSC-EC treated wounds at 7 days post-wounding. Histological analysis of wound sections showed increased capillary density in iPSC-EC wounds at days 7 and 14 post-wounding, and increased collagen content at day 14. Anti-GFP fluorescence confirmed presence of iPSC-ECs in the wounds. Bioluminescent imaging (BLI) showed progressive decline of iPSC-ECs over time, suggesting that iPSC-ECs are acting primarily through short-term paracrine effects. These results highlight the pro-regenerative effects of iPSC-ECs and demonstrate that they are a promising potential therapy for intractable wounds.

Joshi P, Thakur S, Finn C, Sadlier P

J. Heart Valve Dis. 2017 11;26(6):744-746

PMID: 30207130

Abstract

The case described here is the first reported case of successful isolated aortic valve replacement (AVR) via a right anterior thoracotomy (RAT) in a patient with osteogenesis imperfecta (OI). The most common reported complication in patients with OI undergoing AVR or other cardiac surgery is bleeding and sternal complications. By using a RAT approach, it was possible to replace the aortic valve without major bleeding, transfusion, or sternal complications.

Edelman JJ, Rogers T, Khan JM, Thourani VH

J. Thorac. Cardiovasc. Surg. 2018 Aug;

PMID: 30241767

Abstract

Thourani VH, Edelman JJ, Satler LF, Weintraub WS

JACC Cardiovasc Interv 2018 Nov;11(21):2157-2159

PMID: 30343021

Abstract

Edelman JJ, Thourani VH

J. Thorac. Cardiovasc. Surg. 2018 Aug;

PMID: 30172584

Abstract

Filipe EC, Santos M, Hung J, Lee BSL, Yang N, Chan AHP, Ng MKC, Rnjak-Kovacina J, Wise SG

JACC Basic Transl Sci 2018 Feb;3(1):38-53

PMID: 30062193

Abstract

Synthetic vascular grafts for small diameter revascularization are lacking. Clinically available conduits expanded polytetrafluorethylene and Dacron fail acutely due to thrombosis and in the longer term from neointimal hyperplasia. We report the bioengineering of a cell-free, silk-based vascular graft. In vitro we demonstrate strong, elastic silk conduits that support rapid endothelial cell attachment and spreading while simultaneously resisting blood clot and fibrin network formation. In vivo rat studies show complete graft patency at all time points, rapid endothelialization, and stabilization and contraction of neointimal hyperplasia. These studies show the potential of silk as an off-the-shelf small diameter vascular graft.