Faisal H. Cheema

Loyalka P, Ansari MZ, Cheema FH, Miller CC 3rd, Rajagopal S, Rajagopal K. Surgical pulmonary embolectomy and catheter-based therapies for acute pulmonary embolism: A contemporary systematic review. J Thorac Cardiovasc Surg. 2018 Dec;156(6):2155-2167. PMID: 30005883

Objectives: A systematic review of catheter-based therapies (CBT) and surgical pulmonary embolectomy (SE) for acute pulmonary embolism (PE).

Methods: The PubMed database was queried for CBT- and SE-related publications… Show more

Loyalka P, Ansari MZ, Cheema FH, Miller CC 3rd, Rajagopal S, Rajagopal K. Surgical pulmonary embolectomy and catheter-based therapies for acute pulmonary embolism: A contemporary systematic review. J Thorac Cardiovasc Surg. 2018 Dec;156(6):2155-2167. PMID: 30005883

Objectives: A systematic review of catheter-based therapies (CBT) and surgical pulmonary embolectomy (SE) for acute pulmonary embolism (PE).

Methods: The PubMed database was queried for CBT- and SE-related publications between January 1998 and June 2017.

Results: A total of 75 studies (41 of CBT, 34 of SE) were identified, with 1650 patients undergoing CBT and 1101 undergoing SE. Patients undergoing SE were more critically ill than those undergoing CBT (massive PE, 545 out of 975 [55.9%] for SE vs 742 out of 1553 [47.8%] for CBT). Cardiopulmonary resuscitation (CPR) was required in 217 out of 1015 patients undergoing SE (21.4%) versus 38 out of 983 patients undergoing CBT (4.0%). The hospital mortality of SE was 14.0%, versus 5.6% for CBT, in the entire patient group. However, the hospital mortality of SE in patients with pre-SE CPR was 46.3%, whereas it was 6.8% in those patients without pre-SE CPR. Although CPR was associated with an increased risk of mortality both for CBT and SE, it accounted for all of the mortality effect on SE (the adjusted odds ratio for CPR in a random effects model with treatment considered was 9.79 (95% confidence interval, 4.98-19.17; P < .0001). The adjusted odds ratio for mortality for SE relative to CBT was 1.36 (95% confidence interval, 0.80-2.32; P = .84). Moreover, CBT was associated with a procedural failure rate of 8.3%.

Conclusions: Both CBT and SE were associated with satisfactory published outcomes. SE is associated with greater absolute postprocedure mortality than CBT, but has been undertaken in more critically ill populations. Show less

Daoud D, Cheema FH, Morgan JA, Loor G. Sex-Related Differences in Outcomes of Thoracic Organ Transplantation and Mechanical Circulatory Support.
Tex Heart Inst J. 2018 Aug 1;45(4):240-242. eCollection 2018 Aug.
PMID: 30374236

Walther CP, Niu J, Winkelmayer WC, Cheema FH, et al. J Am Heart Assoc. 2018 Jul 6;7(14):e008664. PMID: 29980520

Background: People with end-stage renal disease (ESRD) are at risk for advanced heart failure, but little is known about use and outcomes of durable mechanical circulatory support in this setting. We examined use and outcomes of implantable ventricular assist devices (VADs) in a national ESRD cohort.

Methods and results: We performed a retrospective cohort study of… Show more

Walther CP, Niu J, Winkelmayer WC, Cheema FH, et al. J Am Heart Assoc. 2018 Jul 6;7(14):e008664. PMID: 29980520

Background: People with end-stage renal disease (ESRD) are at risk for advanced heart failure, but little is known about use and outcomes of durable mechanical circulatory support in this setting. We examined use and outcomes of implantable ventricular assist devices (VADs) in a national ESRD cohort.

Methods and results: We performed a retrospective cohort study of Medicare beneficiaries with ESRD who underwent implantable VAD placement from 2006 to 2014. We examined in-hospital and 1-year mortality, all-cause and cause-specific hospitalizations, and heart/kidney transplantation outcomes. We investigated as predictors demographic factors, time-period of VAD implantation, primary or post-cardiotomy implantation, and duration of ESRD before VAD implantation. We identified 96 people with ESRD who underwent implantable VAD placement. At time of VAD implantation, 74 (77.1%) were receiving hemodialysis, 10 (10.4%) were receiving peritoneal dialysis and 12 (12.5%) had renal transplant. Time from incident ESRD to VAD implantation was median 4.0 (interquartile range 1.1, 8.2) years. Mortality during the implantation hospitalization was 40.6%. Within 1 year of implantation 61.5% of people had died. On multivariable analysis, males had half the mortality risk of females. Lower mortality risk was also seen with VAD implantation in a primary setting, and with more recent year of implantation, but these results did not reach statistical significance.

Conclusions: Medicare beneficiaries with ESRD are undergoing durable VAD implantation, often several years after incident ESRD, although in low numbers. Mortality is high among these patients, highlighting the need for investigations to improve treatment selection and management. Show less

Lee TC, Kon Z, Cheema FH, et al. Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database. J Card Surg. 2018 Jan;33(1):7-18. Epub 2018 Jan 4. PMID: 29314257

Purpose: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD.

Methods: Between… Show more

Lee TC, Kon Z, Cheema FH, et al. Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database. J Card Surg. 2018 Jan;33(1):7-18. Epub 2018 Jan 4. PMID: 29314257

Purpose: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD.

Methods: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America.

Results: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension. The most common arterial cannulation strategies included femoral (36%), axillary (27%), and direct aortic (19%). The median perfusion and cross-clamp times were 181 and 102 min, respectively. The lowest temperature on bypass showed significant variation. Hypothermic circulatory arrest (HCA) was used in 78% of cases. Among those undergoing HCA, brain protection strategies included antegrade cerebral perfusion (31%), retrograde cerebral perfusion (25%), both (4%), and none (40%). Median HCA plus cerebral perfusion time was 40 min. Major complications included prolonged ventilation (53%), reoperation (19%), renal failure (18%), permanent stroke (11%), and paralysis (3%). Operative mortality was 17%. The median intensive care unit and hospital length of stays were 4.7 and 9.0 days, respectively. Among 640 centers, the median number of cases performed during the study period was three. Resuscitation, unresponsive state, cardiogenic shock, inotrope use, age >70, diabetes, and female sex were found to be independent predictors of mortality.

Conclusions: These data describe contemporary patient characteristics, operative strategies, and outcomes for AAAD in North America. Mortality and morbidity for AAAD remain high. Show less

Cheema FH, et al. Early Results of the Modified Right Atrial Lesion Set for the Cox-CryoMaze Procedure. Innovations (Phila). 2016 Sep/Oct;11(5):342-348. PMID: 27832044

Objective: The standard right atrial lesion (RAL) set of Cox-Maze III procedure can be technically challenging when using a cryoprobe to create the lesions. We report our initial experience with an alternative set of RALs for the surgical treatment of atrial fibrillation (AF).

Methods: Between 2011-15, a total of… Show more

Cheema FH, et al. Early Results of the Modified Right Atrial Lesion Set for the Cox-CryoMaze Procedure. Innovations (Phila). 2016 Sep/Oct;11(5):342-348. PMID: 27832044

Objective: The standard right atrial lesion (RAL) set of Cox-Maze III procedure can be technically challenging when using a cryoprobe to create the lesions. We report our initial experience with an alternative set of RALs for the surgical treatment of atrial fibrillation (AF).

Methods: Between 2011-15, a total of 112 pts underwent CryoMaze with biatrial cryoablation lesions (-160°C). Although the standard left atrial lesion set was used, the RAL pattern was modified. The intracaval SCV-IVC lesion was performed as in the pattern described for the standard Cox-Maze III procedure. In addition, a horizontal atriotomy incision (the "T" lesion) in the mid free wall of the right atrium was based roughly in the midintercaval line and extended medially as a linear cryolesion to the lateral tricuspid annulus at the so-called 2-o'clock position as in the Cox-Maze III lesion pattern. Our modification consisted of a linear cryolesion directed perpendicularly from the mid portion of the atriotomy (T lesion) to the tip of the RA appendage, which simply interrupted RAA re-entry at another point.

Results: The age was 72±11 years, 56% were males, and 63% had persistent AF. There were three operative deaths. Overall follow-up was 91%. Freedom from AF at discharge, 1,3,6,12, 24-month, and last follow-up [16±11 mo], was 100%, 76%, 84%, 98%, 89%, 89%, and 90%, respectively. Similarly, freedom from antiarrhythmic drugs was 74% and 81%, whereas freedom from anticoagulants was 72% and 78% at 12 and 24 months, respectively.

Conclusions: Modified RAL set is an effective alternative to the traditional RALs of Cox-Maze III. By substituting this lateral RAA lesion for the medial lesion, the procedure becomes easier to perform and favorably impacts operative time while achieving comparable results in reducing AF burden. Show less

Bisleri G, Tononi L, Morgan JA, Bordonali T, Cheema FH, Siddiqui OT, Repossini A, Rosati F, Muneretto C. Separation of mediastinal shed blood during aortic valve surgery elicits a reduced inflammatory response. J Cardiovasc Med (Hagerstown). 2016 Jan;17(1):62-8. PMID: 24933196

AIMS:
The detrimental effects of inflammation following cardiopulmonary bypass (CPB) could negatively affect the postoperative outcome in a specific subset of high-risk patients. We therefore investigated the… Show more

Bisleri G, Tononi L, Morgan JA, Bordonali T, Cheema FH, Siddiqui OT, Repossini A, Rosati F, Muneretto C. Separation of mediastinal shed blood during aortic valve surgery elicits a reduced inflammatory response. J Cardiovasc Med (Hagerstown). 2016 Jan;17(1):62-8. PMID: 24933196

AIMS:
The detrimental effects of inflammation following cardiopulmonary bypass (CPB) could negatively affect the postoperative outcome in a specific subset of high-risk patients. We therefore investigated the impact of a CPB circuit (Admiral, Eurosets, Italy) that allows separation of intracavitary and mediastinal blood on the release of biochemical markers and clinical outcome when compared with a conventional circuit.

METHODS:
Thirty patients undergoing aortic valve surgery were prospectively enrolled and assigned to Admiral group (Group 1, G1, n = 15) or conventional CPB group (Group 2, G2, n = 15). The Admiral oxygenator allows for a separate collection of mediastinal blood processed through a cell-saver before retransfusion. Clinical data and biochemical parameters were measured preoperatively, during CPB and at different time-points postoperatively.

RESULTS:
Preoperative demographics, intraoperative data (as CPB and aortic cross-clamping time) and perioperative complications did not differ between groups. Inflammatory response was significantly decreased in G1, as assessed by means of D-dimer (G1 = 1332.3 ± 953.9 vs. G2 = 2791.9 ± 1740.7 ng/ml, P = 0.02), C-reactive protein (G1 = 169.1 ± 164.8 vs. G2 = 57.1 ± 39.3 mg/l, P = 0.04), interleukin-6 (G1 = 11.8 ± 12.5 vs. G2 = 26.5 ± 24.9 pg/ml, P = 0.02) and tumour necrosis factor-alpha (G1 = 29 ± 28.7 vs. G2 = 45.5 ± 23.6 pg/ml, P = 0.03).

CONCLUSION:
Although no considerable difference was detected in terms of perioperative outcomes, the Admiral oxygenator did result in a significant reduction of inflammatory markers during the early postoperative course. Show less

Three-step open and hybrid surgical treatment for contained rupture of De Bakey Type 3 thoracoabdominal aortic dissection: case report. Bonardelli S1, Battaglia G, Nodari F, De Lucia M, Cervi E, Zanotti C, Matheis A, Muneretto C, Bisleri G, Cheema FH, Giulini SM. J Cardiovasc Med (Hagerstown). 2015 Dec;16(12):852-6. PMID: 26510119

Evans CF, Iacono AT, Sanchez PG, Goloubeva O, Kim J, Timofte I, Cheema FH, Pham SM, Griffith BP, Rajagopal K. Venous Thromboembolic Complications of Lung Transplantation: A Contemporary Single-Institution Review. Ann Thorac Surg. 2015 Dec;100(6):2033-40. PMID: 26363652

BACKGROUND:
The incidence and consequences of deep venous thrombosis (DVT) and pulmonary embolism (PE) have not been described recently in lung transplant recipients. We sought to characterize DVT and PE in a… Show more

Evans CF, Iacono AT, Sanchez PG, Goloubeva O, Kim J, Timofte I, Cheema FH, Pham SM, Griffith BP, Rajagopal K. Venous Thromboembolic Complications of Lung Transplantation: A Contemporary Single-Institution Review. Ann Thorac Surg. 2015 Dec;100(6):2033-40. PMID: 26363652

BACKGROUND:
The incidence and consequences of deep venous thrombosis (DVT) and pulmonary embolism (PE) have not been described recently in lung transplant recipients. We sought to characterize DVT and PE in a contemporary series of lung transplant recipients and describe their association with clinical outcomes.
METHODS:
The records of all lung transplant recipients from July 1, 2008, to June 30, 2013, were reviewed and analyzed. DVT was diagnosed by venous duplex ultrasonography. PE was diagnosed by computed tomography angiography, nuclear ventilation/perfusion scanning, or pulmonary angiography.
RESULTS:
The study comprised 117 patients who underwent 123 transplants. The median age was 63 years (range, 17 to 77 years). Forty-five patients (39%) had evidence of lower extremity DVT, 53 (45%) had no evidence of lower extremity DVT, and 19 (16%) were not tested. Fifty-three (45%) had evidence of upper extremity DVT, 30 (26%) had no evidence of upper extremity DVT, and 34 (29%) were not tested. Eighteen (15%) had evidence of PE, 82 (70%) had no evidence of PE, and 17 (15%) were not tested. A multivariable, stepwise Cox proportional hazards model revealed that the presence of lower extremity DVT (hazard ratio, 2.43; 95% confidence interval, 1.29 to 4.64), use of cardiopulmonary bypass (hazard ratio, 2.21; 95% confidence interval, 1.04 to 4.68), and unilateral lung transplantation (hazard ratio, 2.13; 95% confidence interval, 1.07 to 4.25) were associated with diminished survival.
CONCLUSIONS:
The incidence of DVT and PE in lung transplant recipients is high. Posttransplant surveillance and treatment based on findings are warranted. Show less

Dawood MY, Cheema FH, Ghoreishi M, Foster NW, Villanueva RM, Salenger R, Griffith BP, Gammie JS. Contemporary outcomes of operations for tricuspid valve infective endocarditis. Ann Thorac Surg. 2015 Feb;99(2):539-46. PMID: 25527426

BACKGROUND:
Tricuspid valve infective endocarditis (TVIE) is uncommon. Patients are traditionally treated with antibiotics alone, and indications for operation are not clearly established. We report our operative single-center… Show more

Dawood MY, Cheema FH, Ghoreishi M, Foster NW, Villanueva RM, Salenger R, Griffith BP, Gammie JS. Contemporary outcomes of operations for tricuspid valve infective endocarditis. Ann Thorac Surg. 2015 Feb;99(2):539-46. PMID: 25527426

BACKGROUND:
Tricuspid valve infective endocarditis (TVIE) is uncommon. Patients are traditionally treated with antibiotics alone, and indications for operation are not clearly established. We report our operative single-center experience.

METHODS:
We retrospectively reviewed 56 patients who underwent operations for TVIE between January 2002 and December 2012.

RESULTS:
Methicillin-resistant Staphylococcus aureus was present in 41% of patients, septic pulmonary emboli in 63%, moderate/severe tricuspid regurgitation in 66%, and 86% were intravenous drug abusers. Patients underwent early operation if there was concomitant left-sided endocarditis with indications for operation (n = 18), atrial septal defect (n = 6), infected pacemaker lead (n = 4), or prosthetic TVIE (n = 1). The remaining 27 patients were treated with intravenous antibiotics. Five patients completed a 6-week course of intravenous antibiotics before requiring an operation for symptomatic severe tricuspid regurgitation or persistent bacteremia. Twenty-two patients did not complete the antibiotic therapy and underwent operation for symptomatic severe tricuspid regurgitation (n = 15), persistent fevers/bacteremia (n = 3), or patient-specific factors (n = 4). Valve repair was successful in 57% of patients. Overall operative mortality was 7.1%. No operative deaths occurred in patients with isolated native TVIE. Recurrent TVIE was diagnosed in 21% (5 of 24) of the replacement group and in 0% (0 of 32) in the repair group. Use of repair was strongly protective against recurrent TVIE (p < 0.01).

CONCLUSIONS:
See http://www.ncbi.nlm.nih.gov/pubmed/25527426
Show less

Rehman A, Rahman NG, Harris SM, Cheema FH. Mary Edwards Walker: the soul ahead of her time. JAMA Surg. 2015 Feb;150(2):173-4. PMID: 25535874

Mary Edwards Walker was a gallant woman who stood for women's rights, embodied the true American spirit, and served the Union Army in the Civil War as a surgeon. She later became the first and only woman in United States history to be awarded the Congressional Medal of Honor.

Cheema FH, Heng EE, Rehman A. Pulmonary valve replacement through a left minithoracotomy: an alternate approach. Ann Thorac Surg. 2014 Nov;98(5):1827-9. PMID: 25441797

We present a case of an isolated pulmonary valve endocarditis in a 23-year-old woman with a history of heavy oxycodone abuse. She presented with fever and positive cultures for methicillin-sensitive Staphylococcus aureus. A transesophageal echocardiogram demonstrated a 3-cm vegetation of the pulmonary valve. Antibiotic… Show more

Cheema FH, Heng EE, Rehman A. Pulmonary valve replacement through a left minithoracotomy: an alternate approach. Ann Thorac Surg. 2014 Nov;98(5):1827-9. PMID: 25441797

We present a case of an isolated pulmonary valve endocarditis in a 23-year-old woman with a history of heavy oxycodone abuse. She presented with fever and positive cultures for methicillin-sensitive Staphylococcus aureus. A transesophageal echocardiogram demonstrated a 3-cm vegetation of the pulmonary valve. Antibiotic therapy was started but she continued to have fever and the vegetation size did not change. In view of ongoing fever and risk of embolization, a left minithoracotomy was performed, and the pulmonary valve was replaced with a bioprosthesis using warm cardiopulmonary bypass, with a beating-heart technique. The patient had an uneventful postoperative course and was discharged home. To the best of our knowledge, this is the first case of a pulmonary valve replacement through this approach.

Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. Show less

Younas F, Rahman N, Cheema FH, Rehman A. Large right ventricular laceration during insertion of lariat device. J Interv Card Electrophysiol. 2014 Aug;40(2):169. PMID: 24752793

Hussain N, Rehman A, Cheema FH. Mechanical mitral valve thrombosis in an elderly patient. Int J Cardiovasc Imaging. 2014 Jun;30(5):835-7. PMID: 24748585

Prosthetic valve thrombosis is a rare but dreaded complication of mechanical heart valves. In this clinical picture, we present an elderly female who developed mechanical mitral valve thrombosis several years after mitral valve replacement. We have provided fluoroscopy as well as intraoperative images of mitral valve thrombosis and have… Show more

Hussain N, Rehman A, Cheema FH. Mechanical mitral valve thrombosis in an elderly patient. Int J Cardiovasc Imaging. 2014 Jun;30(5):835-7. PMID: 24748585

Prosthetic valve thrombosis is a rare but dreaded complication of mechanical heart valves. In this clinical picture, we present an elderly female who developed mechanical mitral valve thrombosis several years after mitral valve replacement. We have provided fluoroscopy as well as intraoperative images of mitral valve thrombosis and have briefly discussed the diagnosis, and management of this complication.
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Pervaiz H, Rehman A, Khalid S, Cheema FH. Management for breast implants in patients undergoing mitral valve surgery through a right minithoracotomy. J Card Surg. 2014 May;29(3):323-4. PMID: 24345072


Abstract
We present the surgical technique and rationale for the management of breast implants in two patients who underwent mitral valve repair through a right minithoracotomy.

© 2013 Wiley Periodicals, Inc.

Rehman A, Heng EE, Cheema FH. Calcified amorphous tumour of right ventricle. Lancet. 2014 Mar 1;383(9919):815. PMID: 24529558

Yang KC, Yamada KA, Patel AY, Topkara VK, George I, Cheema FH, Ewald GA, Mann DL, Nerbonne JM. Deep RNA sequencing reveals dynamic regulation of myocardial noncoding RNAs in failing human heart and remodeling with mechanical circulatory support. Circulation. 2014 Mar 4;129(9):1009-21. PMID: 24429688

BACKGROUND:
Microarrays have been used extensively to profile transcriptome remodeling in failing human heart, although the genomic coverage provided is limited and fails to provide a… Show more

Yang KC, Yamada KA, Patel AY, Topkara VK, George I, Cheema FH, Ewald GA, Mann DL, Nerbonne JM. Deep RNA sequencing reveals dynamic regulation of myocardial noncoding RNAs in failing human heart and remodeling with mechanical circulatory support. Circulation. 2014 Mar 4;129(9):1009-21. PMID: 24429688

BACKGROUND:
Microarrays have been used extensively to profile transcriptome remodeling in failing human heart, although the genomic coverage provided is limited and fails to provide a detailed picture of the myocardial transcriptome landscape. Here, we describe sequencing-based transcriptome profiling, providing comprehensive analysis of myocardial mRNA, microRNA (miRNA), and long noncoding RNA (lncRNA) expression in failing human heart before and after mechanical support with a left ventricular (LV) assist device (LVAD).

METHODS AND RESULTS:
Deep sequencing of RNA isolated from paired nonischemic (NICM; n=8) and ischemic (ICM; n=8) human failing LV samples collected before and after LVAD and from nonfailing human LV (n=8) was conducted. These analyses revealed high abundance of mRNA (37%) and lncRNA (71%) of mitochondrial origin. miRNASeq revealed 160 and 147 differentially expressed miRNAs in ICM and NICM, respectively, compared with nonfailing LV. Among these, only 2 (ICM) and 5 (NICM) miRNAs are normalized with LVAD. RNASeq detected 18 480, including 113 novel, lncRNAs in human LV. Among the 679 (ICM) and 570 (NICM) lncRNAs differentially expressed with heart failure, ≈10% are improved or normalized with LVAD. In addition, the expression signature of lncRNAs, but not miRNAs or mRNAs, distinguishes ICM from NICM. Further analysis suggests that cis-gene regulation represents a major mechanism of action of human cardiac lncRNAs.

CONCLUSIONS:
See http://www.ncbi.nlm.nih.gov/pubmed/24429688 Show less

Hussain N, Rehman A, Cheema FH. Twin ostial openings in the left posterior aortic sinus: a pictorial overview of coronary revascularisation and aortic valve replacement in a patient with absent left main artery. BMJ Case Rep. 2014 Mar 28;2014. PMID: 24682143

Cheema FH, Ascha M, Pervez MB, Mannan A, Kossar AP, Polvani G. Patents and Heart Valve Surgery - III: Percutaneous Heart Valves. Recent Pat Cardiovasc Drug Discov. 2014 Jan 23. PMID: 24450590

Advancements in technology for the treatment of valvularcardiac diseases seek to provide solutions for high risk patients in the form of percutaneous valve insertion for patients with complicated valvular disease not amenable to more traditional options. Within the last decade, cardiac valves… Show more

Cheema FH, Ascha M, Pervez MB, Mannan A, Kossar AP, Polvani G. Patents and Heart Valve Surgery - III: Percutaneous Heart Valves. Recent Pat Cardiovasc Drug Discov. 2014 Jan 23. PMID: 24450590

Advancements in technology for the treatment of valvularcardiac diseases seek to provide solutions for high risk patients in the form of percutaneous valve insertion for patients with complicated valvular disease not amenable to more traditional options. Within the last decade, cardiac valves designed for percutaneous insertion have emerged rapidly as a treatment option for valvular disease. This procedure serves as an alternative to open heart surgery, which is more invasive and requires longer ICU stay. Thus, the percutaneous valve insertion procedure has been used on older, frailer patients who are poor candidates for open heart surgery. Designs for percutaneous valve insertion systems have been in development for decades, but have only recently been approved by the FDA for use. Important considerations include stent design, valve design, balloon catheter design, and deployment method. Show less

Recent Pat Cardiovasc Drug Discov. 2013 Aug;8(2):127-42. Patents and heart valve surgery - II: tissue valves. Cheema FH, Kossar AP, Rehman A, Younas F, Polvani G. PMID: 23919429 [PubMed - indexed for MEDLINE]

Abstract
Valvular heart disease affects millions of Americans yearly and currently requires surgical intervention to repair or replace the defective valves. Through a close-knit collaboration between physicians, scientists and biomedical engineers, a vast degree of research and… Show more

Recent Pat Cardiovasc Drug Discov. 2013 Aug;8(2):127-42. Patents and heart valve surgery - II: tissue valves. Cheema FH, Kossar AP, Rehman A, Younas F, Polvani G. PMID: 23919429 [PubMed - indexed for MEDLINE]

Abstract
Valvular heart disease affects millions of Americans yearly and currently requires surgical intervention to repair or replace the defective valves. Through a close-knit collaboration between physicians, scientists and biomedical engineers, a vast degree of research and development has been aimed towards the optimization of prosthetic heart valves. Although various methods have made fantastic strides in producing durable prostheses, the therapeutic efficacy of prosthetic valves is inherently limited by a dependency upon lifelong anticoagulant regimens for recipients - a difficult challenge for many in clinical setting. Thus, biological tissue valves have been developed to circumvent vascular and immunemediated complications by incorporating biological materials to mimic native valves while still maintaining a necessary level of structural integrity. Over the past decade, a multitude of patents pertaining to the refinement of designs as well as the advancement in methodologies and technologies associated with biological tissue valves have been issued. This review seeks to chronicle and characterize such patents in an effort to track the past, present, and future progress as well as project the trajectory of tissue valves in the years to come. Show less

Cheema FH, Younus MJ, Pasha A, Cox JL, Roberts HG Jr. An effective modification to simplify the right atrial lesion set of the cox-cryomaze. Ann Thorac Surg. 2013 Jul;96(1):330-2. PMID: 23816095

Abstract
Reluctance to perform biatrial Cox-cryomaze is primarily to avoid the vexation of creating a right-atrial-lesion (RAL) set of Cox-Maze-III. An alternative pattern of RAL set includes (i) a horizontal atriotomy, continued medially as a linear cryolesion across the posterior tricuspid… Show more

Cheema FH, Younus MJ, Pasha A, Cox JL, Roberts HG Jr. An effective modification to simplify the right atrial lesion set of the cox-cryomaze. Ann Thorac Surg. 2013 Jul;96(1):330-2. PMID: 23816095

Abstract
Reluctance to perform biatrial Cox-cryomaze is primarily to avoid the vexation of creating a right-atrial-lesion (RAL) set of Cox-Maze-III. An alternative pattern of RAL set includes (i) a horizontal atriotomy, continued medially as a linear cryolesion across the posterior tricuspid annulus, (ii) a cavocaval lesion, and (iii) a lateral cryolesion from the midportion of the atriotomy to the tip of the right atrial appendage (RAA). This latter lesion is a substitute for a cryolesion that, in past, was directed medially by a stab wound in the tip of the RAA to the anterior tricuspid annulus. Use of the simplified RAL set, therefore, allows for more deftly achieving a complete biatrial Cox-cryomaze. Show less

Kato TS, Cheema FH, Yang J, Kawano Y, Takayama H, Naka Y, Farr M, Lederer DJ, Baldwin MR, Jin Z, Homma S, Mancini DM, Schulze PC. Preoperative serum albumin levels predict 1-year postoperative survival of patients undergoing heart transplantation. Circ Heart Fail. 2013 Jul;6(4):785-91. PMID: 23674361

Background: Serum albumin concentration has been recognized as a marker of nutrition, severity of inflammation, and hepatic function in patients with various chronic diseases. The purpose of… Show more

Kato TS, Cheema FH, Yang J, Kawano Y, Takayama H, Naka Y, Farr M, Lederer DJ, Baldwin MR, Jin Z, Homma S, Mancini DM, Schulze PC. Preoperative serum albumin levels predict 1-year postoperative survival of patients undergoing heart transplantation. Circ Heart Fail. 2013 Jul;6(4):785-91. PMID: 23674361

Background: Serum albumin concentration has been recognized as a marker of nutrition, severity of inflammation, and hepatic function in patients with various chronic diseases. The purpose of this study was to investigate the impact of pretransplant serum albumin concentration on post-transplant outcome in heart transplant recipients.

Methods and results: Preoperative laboratory variables, including albumin concentration and donor-related information, were obtained from 822 consecutive patients undergoing heart transplant at Columbia University Medical Center between 1999-2010. The association between pretransplant albumin concentration and post-transplant 1-year survival was analyzed. Available data from the United Network for Organ Sharing (n=13671) were also analyzed to evaluate the impact of preoperative albumin levels on post-transplant outcome. In our cohort, multivariable analysis revealed that preoperative albumin (mg/dL; hazard ratio, 0.46; P<0.0001) and preoperative total bilirubin (mg/dL; hazard ratio, 1.26; P=0.0002) were associated with post-transplant 1-year mortality. This implied that for every 1 mg/dL increase in albumin concentration, the post-transplant 1-year mortality rate decreased by 54%. The Kaplan-Meier analysis based on our patients cohort and the UNOS dataset showed lower survival rate at 1-year post-transplant in patients with albumin levels ≤ 3.5 mg/dL compared with those with >3.5 mg/dL (our patients, 91.3 versus 72.4%; P<0.0001; United Network for Organ Sharing, 88.4 versus 84.8%; P<0.0001).

Conclusions: Pretransplant serum albumin concentration is a strong prognostic marker for post-transplant survival in heart transplant recipients. Show less

Cheema FH, Roberts HG Jr. Staged percutaneous coronary intervention and minimally invasive valve surgery: Results of a hybrid approach to concomitant coronary and valvular disease. J Thorac Cardiovasc Surg. 2013 Jun;145(6):1684. PMID: 23679974

Cheema FH, Hussain N, Kossar A, Polvani G. Patents and Heart Valve Surgery - I: Mechanical Valves. Recent Pat Cardiovasc Drug Discov. 2013 May 23. [Epub ahead of print] PMID: 23713961

Valvular heart disease, inherited or acquired, affects more than 5 million Americans yearly. Whereas medical treatment is beneficial in the initial stages of valvular heart disease; surgical correction provides symptomatic relief and long-term survival benefits. Surgical options include either repair or… Show more

Cheema FH, Hussain N, Kossar A, Polvani G. Patents and Heart Valve Surgery - I: Mechanical Valves. Recent Pat Cardiovasc Drug Discov. 2013 May 23. [Epub ahead of print] PMID: 23713961

Valvular heart disease, inherited or acquired, affects more than 5 million Americans yearly. Whereas medical treatment is beneficial in the initial stages of valvular heart disease; surgical correction provides symptomatic relief and long-term survival benefits. Surgical options include either repair or replacement using mechanical or bio-prosthetic valves. Age and need for anticoagulation are major determinants for choosing mechanical versus bio-prosthetic valves. Since the first mechanical valves were made available several decades ago, constant improvements have been made to incorporate the newer materials and the modifications in the valve designs. To this end, various mechanical heart valve patents have been issued over time with the advent of technology. In this paper, we have chronologically reviewed such patents as well as briefly touched upon the current major challenges faced with mechanical heart valve and how different heart valve designs can be used to overcome such challenges. A heart valve that would mimic the natural hemodynamics and physiology of the native heart valve will be an ideal valve. Such a valve should be easy to implant, must have a minimum associated risk of thrombosis and thus need for anti-coagulation, and is proven to have long-term durability. With cutting edge technological advancements and the on-going close collaborations of physician scientists and engineers patenting an ideal valve in the near future may be possible. Show less

Schulze PC, Jiang J, Yang J, Cheema FH, Schaeffle K, Kato TS, Farr M, Restaino S, Deng M, Maurer M, Horn E, Latif F, Colombo PC, Jorde U, Uriel N, Haythe J, Bijou R, Drusin R, Lee SH, Takayama H, Naka Y, Mancini DM. Preoperative assessment of high-risk candidates to predict survival after heart transplantation. Circ Heart Fail. 2013 May 1;6(3):527-34.PMID: 23505300

Background- Alternate waiting list strategies expand listing criteria for patients awaiting heart transplantation (HTx). We… Show more

Schulze PC, Jiang J, Yang J, Cheema FH, Schaeffle K, Kato TS, Farr M, Restaino S, Deng M, Maurer M, Horn E, Latif F, Colombo PC, Jorde U, Uriel N, Haythe J, Bijou R, Drusin R, Lee SH, Takayama H, Naka Y, Mancini DM. Preoperative assessment of high-risk candidates to predict survival after heart transplantation. Circ Heart Fail. 2013 May 1;6(3):527-34.PMID: 23505300

Background- Alternate waiting list strategies expand listing criteria for patients awaiting heart transplantation (HTx). We retrospectively analyzed clinical events and outcome of patients listed as high-risk recipients for HTx. Methods and Results- We analyzed 822 adult patients who underwent HTx of whom 111 patients met high-risk criteria. Clinical data were collected from medical records and outcome factors calculated for 61 characteristics. Significant factors were summarized in a prognostic score. Age >65 years (67%) and amyloidosis (19%) were the most common reasons for alternate listing. High-risk recipients were older (63.2±10.2 versus 51.4±11.8 years; P<0.001), had more renal dysfunction, prior cancer, and smoking. Survival analysis revealed lower post-HTx survival in high-risk recipients (82.2% versus 87.4% at 1-year; 59.8% versus 76.3% at 5-year post-HTx; P=0.0005). Prior cerebral vascular accident, albumin <3.5 mg/dL, re-HTx, renal dysfunction (glomerular filtration rate <40 mL/min), and >2 prior sternotomies were associated with poor survival after HTx. A prognostic risk score (CARRS [CVA, albumin, re-HTx, renal dysfunction, and sternotomies]) derived from these factors stratified survival post-HTx in high-risk (3+ points) versus low-risk (0-2 points) patients (87.9% versus 52.9% at 1-year; 65.9% versus 28.4% at 5-year post-HTx; P<0.001). Low-risk alternate patients had survival comparable with regular patients (87.9% versus 87.0% at 1-year and 65.9% versus 74.5% at 5-year post-HTx; P=0.46). Conclusions: Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/23505300 Show less

Cheema FH, Cheung S, Jiang J, Younus MJ, Roberts HG Jr. Robotic multisegment triangular resections as an alternative to sliding leaflet plasty. Innovations (Phila). 2013 May-Jun;8(3):237-41. PMID: 23989820

The sliding leaflet plasty of the posterior mitral leaflet is a complex procedure, both lengthy and technically challenging. A simple alternative is desirable, particularly for a minimally invasive approach. We report a distinct substitute to the conventional sliding leaflet plasty… Show more

Cheema FH, Cheung S, Jiang J, Younus MJ, Roberts HG Jr. Robotic multisegment triangular resections as an alternative to sliding leaflet plasty. Innovations (Phila). 2013 May-Jun;8(3):237-41. PMID: 23989820

The sliding leaflet plasty of the posterior mitral leaflet is a complex procedure, both lengthy and technically challenging. A simple alternative is desirable, particularly for a minimally invasive approach. We report a distinct substitute to the conventional sliding leaflet plasty that included triangular resections of P2 and P3 using a robot. These multiple triangular resections enabled a successful mitral valve repair with satisfactory clinical and echocardiographic results. Recognizing the complexity of sliding leaflet plasties, we note that multisegment triangular resections seem to be an easy, expeditious, and effective alternative for the posterior leaflet that is readily performed via a robotic endoscopic approach. Show less

Cheema FH, Pervez MB, Mehmood M, Younus MJ, Munir MB, Bisleri G, Barili F, Ayala IL, Ad N, Cox JL, Roberts HG Jr. Does cryomaze injure the circumflex artery?: a preliminary search for occult postprocedure stenoses. Innovations (Phila). 2013 Jan-Feb;8(1):56-66. PMID: 23571795

OBJECTIVE:
Ensuring the transmurality of the mitral isthmus lesion, a critical component of the cryomaze, entails mirror-image application of the cryoprobe both on endocardial and epicardial surfaces when carrying… Show more

Cheema FH, Pervez MB, Mehmood M, Younus MJ, Munir MB, Bisleri G, Barili F, Ayala IL, Ad N, Cox JL, Roberts HG Jr. Does cryomaze injure the circumflex artery?: a preliminary search for occult postprocedure stenoses. Innovations (Phila). 2013 Jan-Feb;8(1):56-66. PMID: 23571795

OBJECTIVE:
Ensuring the transmurality of the mitral isthmus lesion, a critical component of the cryomaze, entails mirror-image application of the cryoprobe both on endocardial and epicardial surfaces when carrying out ablation. Concerns of circumflex artery injury have been expressed during the epicardial application of the cryoprobe over the coronary sinus as the artery courses on the posterior surface of the sinus in the atrioventricular (AV) groove. The objective of this study was to analyze the incidence of significant injury to the circumflex artery and its impact on outcomes, if any, in those patients who have undergone cryomaze.
METHODS:
Between Aug'04 and Dec'09, a total of 223 patients underwent argon-based cryoablation (120-second application at -140°C). After WIRB approval, 20 consecutive patients with normal results of preoperative coronary angiograms (right dominance, 75%; left dominance, 15%; codominant circulation, 10%) and who were at least 6 months postablation were enrolled in this study. The mean ± SD age was 60.74 ± 14.99 years, 35% were men, and 50% belonged to NYHA III/IV. The mean AF duration was 23.83 ± 36.28 months (65% were paroxysmal). Ten percent (n = 2) underwent primary cryomaze, 40% (n = 8) underwent cryomaze plus mitral valve repair, and 50% (n = 10) underwent two or more concomitant valvular procedures. Twelve patients underwent biatrial cryomaze, and eight underwent only left-sided cryomaze. All patients underwent a 24 hr Holter, electrocardiogram stress test, and a coronary CTA, as per the protocol of this study.
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/23571795
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/23571795 Show less

Cheema FH, Roberts HG Jr. Advancing the understanding of surgical cryothermy. Innovations (Phila). 2012 Nov-Dec;7(6):387-8. PMID: 23422798

Barili F, Barzaghi N, Cheema FH, Capo A, Jiang J, Ardemagni E, Argenziano M, Grossi C. An original model to predict Intensive Care Unit length-of stay after cardiac surgery in a competing risk framework. Int J Cardiol. 2012 Oct 3. pii: S0167-5273(12)01197-7. PMID: 23040076

BACKGROUND:
The aim of the study is to design a specific Intensive Care Unit length-of-stay risk model based on the preoperative factors and surgeries utilizing modeling strategies for time-to-event data in a… Show more

Barili F, Barzaghi N, Cheema FH, Capo A, Jiang J, Ardemagni E, Argenziano M, Grossi C. An original model to predict Intensive Care Unit length-of stay after cardiac surgery in a competing risk framework. Int J Cardiol. 2012 Oct 3. pii: S0167-5273(12)01197-7. PMID: 23040076

BACKGROUND:
The aim of the study is to design a specific Intensive Care Unit length-of-stay risk model based on the preoperative factors and surgeries utilizing modeling strategies for time-to-event data in a prospective observational clinical study.
METHODS:
From January 2004 to April 2011 data on 3861 consecutive heart surgery patients were prospectively collected. ICU length of stay was analyzed as a time-to-event variable in a competing risk framework with death as competing risk.
RESULTS:
The median ICU-LOS was one day. All factors considered but gender was included in the multivariable modeling. In the final model, factors that mostly affected time-to-discharge from ICU were critical preoperative state (Relative Risk 0.41; 95% Confidence Interval: 0.29-0.58), emergency (0.41; 0.32-0.53), poor left ventricular dysfunction (0.50; 0.44-0.57) and serum creatinine>200μmol/L (0.54; 0.46-0.65). Most of the predictors had a time-dependent effect that decreased in the first fifteen days and was constant thereafter. After the plateau, the risk profile was changed as most of the factors were no longer significant, Conversely, the time-to-ICU death model included only two variables, critical perioperative state and serum creatinine>200μmol/L, with a constant RR of 9.1 and 3.37 respectively.
CONCLUSIONS:
ICU-LOS can be predicted by preoperative data and type of surgeries. The derived ICU-LOS prediction model is dynamic and most predictors have an effect that decreases with time. The algorithm can preoperatively predict ICU-LOS curves and could have a major role in the decision making-behavior of clinicians, resources' allocation and maximization of care for high-risk patients. Show less

Rosato F, Bruzzone D, Cheema FH, Capo A, Ardemagni E, Verna A, Rosano S, Grossi C, Barili F. Hemoglobin trends in isolated coronary artery bypass grafting performed off-pump and with standard and mini circuits. Artif Organs. 2012 Oct;36(10):868-74. PMID: 22845744

The comparison of hemodilution at the end of surgery is of limited use as it represents only a snapshot of a dynamic phenomenon. This study was undertaken to compare the perioperative hemoglobin (Hb) curves of isolated coronary… Show more

Rosato F, Bruzzone D, Cheema FH, Capo A, Ardemagni E, Verna A, Rosano S, Grossi C, Barili F. Hemoglobin trends in isolated coronary artery bypass grafting performed off-pump and with standard and mini circuits. Artif Organs. 2012 Oct;36(10):868-74. PMID: 22845744

The comparison of hemodilution at the end of surgery is of limited use as it represents only a snapshot of a dynamic phenomenon. This study was undertaken to compare the perioperative hemoglobin (Hb) curves of isolated coronary artery bypass grafting performed with minimized extracorporeal circulation, traditional cardiopulmonary bypass, and off-pump technique. The propensity score method was used to select three groups of patients, homogenous regarding preoperative and operative data, who underwent isolated CABG. A generalized linear mixed model was used for estimating differences in perioperative hemoglobin trends among groups. The three groups were each composed of 50 patients with no differences in demographic data, preoperative risk profile, preoperative Hb, or type of surgery. There was no significant difference in major postoperative complications. The pattern of the hemodilution curves was similar in patients operated with mini-circuit and off-pump technique (P > 005). Mini-circuit led to a 3.1 ± 11.9% Hb reduction, which was similar to the off-pump group (1.6 ± 8.9%, P = 0.99 at ANOVA) and significantly different from the standard extracorporeal circuit group (16.0 ± 10.3%, P < 0.001 at ANOVA). The generalized linear mixed model determined that the standard circuit was the only independent predictor for increased hemodilution. Its effect on hemodilution was time-dependent and the slope of the Hb curve was more pronounced between systemic heparinization and the end of surgery. Perioperative Hb trends of patients who underwent myocardial revascularization with mini-circuit were similar to those of off-pump surgery and significantly less pronounced than those of standard extracorporeal circulation. Show less

Heng EE, Argenziano M, Cheema FH. Fundamental flaw in a fundamental measure: inaccuracies in death data reporting. Ann Thorac Surg. 2012 Aug;94(2):692-3. PMID: 22818331

Bisleri G, Curnis A, Cheema FH, Muneretto C. Sequential hybrid ablation for persistent atrial fibrillation. Ann Thorac Surg. 2012 Aug;94(2):689-90. PMID: 22818327

Muneretto C, Bisleri G, Bontempi L, Cheema FH, Curnis A. Successful treatment of lone persistent atrial fibrillation by means of a hybrid thoracoscopic-transcatheter approach. Innovations (Phila). 2012 Jul-Aug;7(4):254-8. PMID: 23123991

OBJECTIVE:
Ablation strategies for the treatment of lone persistent atrial fibrillation (AF) have rapidly evolved during the past decade both with electrophysiological (EP) and surgical approaches. We investigated the safety and efficacy of a novel… Show more

Muneretto C, Bisleri G, Bontempi L, Cheema FH, Curnis A. Successful treatment of lone persistent atrial fibrillation by means of a hybrid thoracoscopic-transcatheter approach. Innovations (Phila). 2012 Jul-Aug;7(4):254-8. PMID: 23123991

OBJECTIVE:
Ablation strategies for the treatment of lone persistent atrial fibrillation (AF) have rapidly evolved during the past decade both with electrophysiological (EP) and surgical approaches. We investigated the safety and efficacy of a novel staged hybrid approach combining surgical thoracoscopic and EP ablation in patients with lone persistent AF.
METHODS:
Twenty-four consecutive patients with either persistent (three patients, 12.5%) or long-standing persistent (21 patients, 87.5%) isolated AF were prospectively enrolled: the mean age was 63.2 ± 9.3 years, the mean left atrial dimension was 50.5 ± 8 mm, and the mean AF duration was 82.7 months (range, 7-240 months). The surgical procedure consisted of a monolateral, right-sided, thoracoscopic closed-chest approach to perform a "box" lesion set with a temperature-controlled, internally cooled, radiofrequency monopolar device with suction adherence (Cobra Adhere XL; Estech, San Ramon, CA USA). A continuous monitoring rhythm device (Reveal XT; Medtronic, Minneapolis, MN USA) was implanted at the time of surgery in all patients for continuous long-term monitoring of the heart rhythm.
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/23123991
CONCLUSIONS:
The combination of thoracoscopic box lesion and transcatheter ablation in a staged hybrid approach proved to be safe, providing excellent mid-term clinical outcomes in patients with long-standing, isolated, persistent AF. Moreover, the implantable loop recorders documented such incremental benefits in sinus rhythm restoration for up to 28 months. Show less

Chokshi A, Cheema FH, Schaefle KJ, Jiang J, Collado E, Shahzad K, Khawaja T, Farr M, Takayama H, Naka Y, Mancini DM, Schulze PC. Hepatic dysfunction and survival after orthotopic heart transplantation: application of the MELD scoring system for outcome prediction. J Heart Lung Transplant. 2012 Jun;31(6):591-600. PMID: 22458996

Abstract
BACKGROUND:
The prevalence of heart failure (HF) is rising and the only corrective treatment is cardiac transplantation. Advanced HF is associated… Show more

Chokshi A, Cheema FH, Schaefle KJ, Jiang J, Collado E, Shahzad K, Khawaja T, Farr M, Takayama H, Naka Y, Mancini DM, Schulze PC. Hepatic dysfunction and survival after orthotopic heart transplantation: application of the MELD scoring system for outcome prediction. J Heart Lung Transplant. 2012 Jun;31(6):591-600. PMID: 22458996

Abstract
BACKGROUND:
The prevalence of heart failure (HF) is rising and the only corrective treatment is cardiac transplantation. Advanced HF is associated with congestive hepatopathy and progressive functional and ultrastructural changes of the liver. We hypothesized that hepatic dysfunction is associated with impaired clinical outcome after heart transplantation.
METHODS:
Data of 617 adult patients (75% men, mean age 53 ± 12 years, mean BMI 25 ± 4, mean ejection fraction 19 ± 9%) undergoing orthotopic heart transplantation (OHT) were analyzed retrospectively. Deviation from institutional normal ranges was used to define abnormal liver function. Standard Model for End-stage Liver Disease (MELD) scores were calculated and a modified MELD score with albumin replacing INR (modMELD) was created to eliminate the confounding effects of anti-coagulation.
RESULTS:
Before OHT, AST, ALT and total bilirubin were elevated in 20%, 18% and 29% of the population, respectively. Total protein and albumin were decreased in 25% and 52% of the population, respectively. By 2 months post-transplantation, percentages of individuals with pathologic values decreased significantly, except for ALT, total protein and albumin, all of which took longer to normalize. Individuals with a higher pre-transplantation MELD or modMELD score had worse outcome 30 days post-transplant and reduced long-term survival over a 10-year follow-up.
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/22458996 Show less

Oliver JA, Maarouf O, Cheema FH, Liu C, Zhang QY, Kraus C, Zeeshan Afzal M, Firdous M, Klinakis A, Efstratiadis A, Al-Awqati Q. SDF-1 activates papillary label-retaining cells during kidney repair from injury. Am J Physiol Renal Physiol. 2012 Jun 1;302(11):F1362-73. PMID: 22461304

Abstract
The adult kidney contains a population of low-cycling cells that resides in the papilla. These cells retain for long periods S-phase markers given as a short pulse early in life; i.e., they are… Show more

Oliver JA, Maarouf O, Cheema FH, Liu C, Zhang QY, Kraus C, Zeeshan Afzal M, Firdous M, Klinakis A, Efstratiadis A, Al-Awqati Q. SDF-1 activates papillary label-retaining cells during kidney repair from injury. Am J Physiol Renal Physiol. 2012 Jun 1;302(11):F1362-73. PMID: 22461304

Abstract
The adult kidney contains a population of low-cycling cells that resides in the papilla. These cells retain for long periods S-phase markers given as a short pulse early in life; i.e., they are label-retaining cells (LRC). In previous studies in adult rat and mice, we found that shortly after acute kidney injury many of the quiescent papillary LRC started proliferating (Oliver JA, Klinakis A, Cheema FH, et al. JASN 20: 2315-2327, 2009; Oliver JA, Maarouf O, Cheema FH, et al. J Clin Invest 114: 795-804, 2004) and, with cell-tracking experiments, we found upward migration of some papillary cells including LRC (Oliver JA, Klinakis A, Cheema FH, Friedlander J, Sampogna RV, Martens TP, Liu C, Efstratiadis A, Al-Awqati Q. J Am Soc Nephrol 20: 2315-2327, 2009). To identify molecular cues involved in the activation (i.e., proliferation and/or migration) of the papillary LRC that follows injury, we isolated these cells from the H2B-GFP mice and found that they migrated and proliferated in response to the cytokine stromal cell-derived factor-1 (SDF-1). Moreover, in a papillary organ culture assay, the cell growth out of the upper papilla was dependent on the interaction of SDF-1 with its receptor Cxcr4. Interestingly, location of these two proteins in the kidney revealed a complementary location, with SDF-1 being preferentially expressed in the medulla and Cxcr4 more abundant in the papilla. Blockade of Cxcr4 in vivo prevented mobilization of papillary LRC after transient kidney ischemic injury and worsened its functional consequences. The data indicate that the SDF-1/Cxcr4 axis is a critical regulator of papillary LRC activation following transient kidney injury and during organ repair. Show less

Chokshi A, Drosatos K, Cheema FH, Ji R, Khawaja T, Yu S, Kato T, Khan R, Takayama H, Knöll R, Milting H, Chung CS, Jorde U, Naka Y, Mancini DM, Goldberg IJ, Schulze PC. Ventricular assist device implantation corrects myocardial lipotoxicity, reverses insulin resistance, and normalizes cardiac metabolism in patients with advanced heart failure. Circulation. 2012 Jun 12;125(23):2844-53. PMID: 22586279

Abstract
BACKGROUND:
Heart failure is associated with impaired myocardial… Show more

Chokshi A, Drosatos K, Cheema FH, Ji R, Khawaja T, Yu S, Kato T, Khan R, Takayama H, Knöll R, Milting H, Chung CS, Jorde U, Naka Y, Mancini DM, Goldberg IJ, Schulze PC. Ventricular assist device implantation corrects myocardial lipotoxicity, reverses insulin resistance, and normalizes cardiac metabolism in patients with advanced heart failure. Circulation. 2012 Jun 12;125(23):2844-53. PMID: 22586279

Abstract
BACKGROUND:
Heart failure is associated with impaired myocardial metabolism with a shift from fatty acids to glucose use for ATP generation. We hypothesized that cardiac accumulation of toxic lipid intermediates inhibits insulin signaling in advanced heart failure and that mechanical unloading of the failing myocardium corrects impaired cardiac metabolism.
METHODS AND RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/22586279
CONCLUSIONS:
Mechanical unloading after left ventricular assist device implantation corrects systemic and local metabolic derangements in advanced heart failure, leading to reduced myocardial levels of toxic lipid intermediates and improved cardiac insulin signaling. Show less

Khan RS, Kato TS, Chokshi A, Chew M, Yu S, Wu C, Singh P, Cheema FH, Takayama H, Harris C, Reyes-Soffer G, Knöll R, Milting H, Naka Y, Mancini D, Schulze PC. Adipose tissue inflammation and adiponectin resistance in patients with advanced heart failure: correction after ventricular assist device implantation. Circ Heart Fail. 2012 May 1;5(3):340-8. PMID: 22379072

Abstract
BACKGROUND:
Heart failure (HF) is characterized by inflammation, insulin resistance, and progressive… Show more

Khan RS, Kato TS, Chokshi A, Chew M, Yu S, Wu C, Singh P, Cheema FH, Takayama H, Harris C, Reyes-Soffer G, Knöll R, Milting H, Naka Y, Mancini D, Schulze PC. Adipose tissue inflammation and adiponectin resistance in patients with advanced heart failure: correction after ventricular assist device implantation. Circ Heart Fail. 2012 May 1;5(3):340-8. PMID: 22379072

Abstract
BACKGROUND:
Heart failure (HF) is characterized by inflammation, insulin resistance, and progressive catabolism. We hypothesized that patients with advanced HF also develop adipose tissue inflammation associated with impaired adipokine signaling and that hemodynamic correction through implantation of ventricular assist devices (VADs) would reverse adipocyte activation and correct adipokine signaling in advanced HF.
METHODS AND RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/22379072
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/22379072 Show less

Cheema FH, Polvani G, Argenziano M, Pesce M. Combining stem cells and tissue engineering in cardiovascular repair -- a step forward to derivation of novel implants with enhanced function and self-renewal characteristics. Recent Pat Cardiovasc Drug Discov. 2012 Apr;7(1):10-20. PMID: 22280334

Abstract
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/22280334

Chan EY, Lumbao DM, Iribarne A, Easterwood R, Yang JY, Cheema FH, Smith CR, Argenziano M. Evolution of cannulation techniques for minimally invasive cardiac surgery: a 10-year journey. Innovations (Phila). 2012 Jan-Feb;7(1):9-14. PMID: 22576030

Abstract
OBJECTIVE:
For minimally invasive cardiac surgery (MICS) procedures requiring cardiopulmonary bypass (CPB), cannulation techniques vary and seem to be important determinants of technical difficulty and clinical outcomes. Over 10… Show more

Chan EY, Lumbao DM, Iribarne A, Easterwood R, Yang JY, Cheema FH, Smith CR, Argenziano M. Evolution of cannulation techniques for minimally invasive cardiac surgery: a 10-year journey. Innovations (Phila). 2012 Jan-Feb;7(1):9-14. PMID: 22576030

Abstract
OBJECTIVE:
For minimally invasive cardiac surgery (MICS) procedures requiring cardiopulmonary bypass (CPB), cannulation techniques vary and seem to be important determinants of technical difficulty and clinical outcomes. Over 10 years of MICS, we have modified our techniques substantially, and the present report outlines the evolution of our current cannulation platform.
METHODS:
From October 2000 to November 2010, 1087 minimally invasive cardiac procedures were performed at our institution; of these, 165 were done without CPB and were excluded. Methods of arterial and venous cannulation and aortic occlusion were retrospectively reviewed. Outcomes of interest included CPB and aortic cross-clamp time, as well as rates of in-hospital stroke, myocardial infarction, and short- and long-term mortality.
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/22576030
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/22576030 Show less

Cheema FH, Younus MJ, Roberts HG Jr. Repairing the posterior postinfarction ventricular septal defect: a left ventricular approach with a sealant reinforced multipatch technique. Semin Thorac Cardiovasc Surg. 2012 Spring;24(1):63-6. PMID: 22643664

An uncommon complication of acute myocardial infarction (AMI), postinfarction ventricular septal defect (PI-VSD), often yields devastating outcomes. Because of the strikingly poor quality of the residual tissue, the repair of PI-VSD poses a… Show more

Cheema FH, Younus MJ, Roberts HG Jr. Repairing the posterior postinfarction ventricular septal defect: a left ventricular approach with a sealant reinforced multipatch technique. Semin Thorac Cardiovasc Surg. 2012 Spring;24(1):63-6. PMID: 22643664

An uncommon complication of acute myocardial infarction (AMI), postinfarction ventricular septal defect (PI-VSD), often yields devastating outcomes. Because of the strikingly poor quality of the residual tissue, the repair of PI-VSD poses a surgical challenge and is associated with high operative mortality as well as residual or recurrent shunting. Among the various techniques that have been developed, we prefer a left ventricular approach to repairing PI-VSD by using a multipatch technique reinforced with a sealant as an adjunct to surgical repair. In this method, 3 patches are used: two overlay the left side of the VSD with a sealant (composed of albumin cross-linked to glutaraldehyde) sandwiched between them, whereas a third patch is used to cover the ventriculotomy defect. The rationale is that the use of such a sealant decreases the complications of PI-VSD repair by providing a sturdier surface for suture placement, thereby decreasing suture dehiscence and consequent recurrence of septal rupture. This multipatch technique offers hope in improving the results of the surgical management of PI-VSD. Show less

Barili F, Cheema FH, Barzaghi N, Grossi C. The analysis of intensive care unit length of stay in a competing risk setting. Eur J Cardiothorac Surg. 2012 Jan;41(1):232. PMID: 21600782

Worku B, Naka Y, Pak SW, Cheema FH, Siddiqui OT, Jain J, Uriel N, Bhatt R, Colombo P, Jorde U, Takayama H. Predictors of mortality after short-term ventricular assist device placement. Ann Thorac Surg. 2011 Nov;92(5):1608-12. PMID: 22051257

Abstract
BACKGROUND:
Risk assessment prior to long-term ventricular assist device (VAD) placement has been shown to be crucial for successful outcomes and efficient resource utilization. Short-term VADs are often used as salvage therapy in acute… Show more

Worku B, Naka Y, Pak SW, Cheema FH, Siddiqui OT, Jain J, Uriel N, Bhatt R, Colombo P, Jorde U, Takayama H. Predictors of mortality after short-term ventricular assist device placement. Ann Thorac Surg. 2011 Nov;92(5):1608-12. PMID: 22051257

Abstract
BACKGROUND:
Risk assessment prior to long-term ventricular assist device (VAD) placement has been shown to be crucial for successful outcomes and efficient resource utilization. Short-term VADs are often used as salvage therapy in acute heart failure when the clinical scenario precludes such thorough preoperative assessment. Our goal was to devise a risk stratification system that may be used shortly after stabilization of hemodynamics with a short-term VAD to predict the likelihood of survival.
METHODS:
A retrospective study was performed of all patients undergoing Abiomed (Abiomed Cardiovascular Inc., Danvers, MA) or CentriMag (Levitronix LLC, Waltham, MA) placement at our institution or transferred to our institution with the device in place. From January 2001 until August 2009, 93 patients were identified. Preoperative and early postoperative variables were analyzed for their correlation with in-hospital mortality.
RESULTS:
Multivariable logistic regression analysis identified factors that were associated with death. A three-point scoring system, utilizing a diagnosis of postcardiotomy shock or graft failure, female sex, and postoperative day 3 total bilirubin greater than 5.2 mg/dL was devised. A score of 2 or greater was associated with an 86% mortality rate, whereas a score of 0 was associated with a 13% mortality rate.
CONCLUSIONS:
A simple scoring system based on readily available data may predict mortality after short-term VAD placement. Such a scoring system may be of prognostic value for physicians and patient families early in the support period and may help guide decisions. Show less

Rafiullah F, Kanwal S, Majeed UM, Korsten MA, Cheema FH, Luthra M, Sohail MR. Successful use of nitazoxanide in the treatment of recurrent Clostridium difficile infection. BMJ Case Rep. 2011 Nov 21;2011. PMID: 22674696

Abstract
A 78-year-old, retired Caucasian male presented in emergency room with 3 days history of progressive watery diarrhoea. Two weeks earlier, he received intravenous levofloxacin for community acquired pneumonia. The patient was diagnosed as severe Clostridium… Show more

Rafiullah F, Kanwal S, Majeed UM, Korsten MA, Cheema FH, Luthra M, Sohail MR. Successful use of nitazoxanide in the treatment of recurrent Clostridium difficile infection. BMJ Case Rep. 2011 Nov 21;2011. PMID: 22674696

Abstract
A 78-year-old, retired Caucasian male presented in emergency room with 3 days history of progressive watery diarrhoea. Two weeks earlier, he received intravenous levofloxacin for community acquired pneumonia. The patient was diagnosed as severe Clostridium difficile infection based on clinical presentation, labs and imaging studies. The patient was initially treated with intravenous metronidazole and oral vancomycin. While awaiting subacute rehabilitation placement, the patient relapsed twice. After first recurrence the patient was treated with 2 weeks of oral nitazoxanide. After second recurrence, the patient was treated 2 weeks of nitazoxanide followed by tapering dose of vancomycin. The patient was followed and no relapse was reported at 1 year follow-up visit. Show less

Agrifoglio M, Pontone G, Andreini D, Biglioli P, Cheema FH, Barili F. Conservative management of the pseudoaneurysms of ascending aortic graft: a case of spontaneous regression at follow-up. J Cardiovasc Med (Hagerstown). 2011 Aug;12(8):586-8. PMID: 21532497

Abstract
Pseudoaneurysms of thoracic aorta represent life-threatening complications of cardiac surgery. We present a case report of a patient who underwent urgent aortic valvular replacement with a biological prosthesis and… Show more

Agrifoglio M, Pontone G, Andreini D, Biglioli P, Cheema FH, Barili F. Conservative management of the pseudoaneurysms of ascending aortic graft: a case of spontaneous regression at follow-up. J Cardiovasc Med (Hagerstown). 2011 Aug;12(8):586-8. PMID: 21532497

Abstract
Pseudoaneurysms of thoracic aorta represent life-threatening complications of cardiac surgery. We present a case report of a patient who underwent urgent aortic valvular replacement with a biological prosthesis and ascending aortic replacement with graft interposition and developed postoperative ascending aortic pseudoaneurysms. The pseudoaneurysms did not increase in the postoperative stay and a conservative management was chosen. At follow-up, the two pseudoaneurysms had completely regressed. The therapeutic steps for aortic pseudoaneurysms should be tailored to the patient and even conservative management could be effective if selected after an evaluation of the clinical status of the patient. Show less

Bisleri G, Cheema FH, Muneretto C. Detrimental impact of endoscopic vein harvesting: a word of caution. J Thorac Cardiovasc Surg. 2011 Aug;142(2):481. PMID: 21763888

Ahmed D, Cheema FH, Ahmed YI, Schaefle KJ, Azam SI, Sami SA, Sharif HM. Incidence and predictors of infection in patients undergoing primary isolated coronary artery bypass grafting: a report from a tertiary care hospital in a developing country. J Cardiovasc Surg (Torino). 2011 Feb;52(1):99-104. PMID: 21224817

Abstract
AIM:
Infection following coronary artery bypass grafting (CABG) is a leading cause of morbidity, mortality, and increased length of hospital stay. Many studies have… Show more

Ahmed D, Cheema FH, Ahmed YI, Schaefle KJ, Azam SI, Sami SA, Sharif HM. Incidence and predictors of infection in patients undergoing primary isolated coronary artery bypass grafting: a report from a tertiary care hospital in a developing country. J Cardiovasc Surg (Torino). 2011 Feb;52(1):99-104. PMID: 21224817

Abstract
AIM:
Infection following coronary artery bypass grafting (CABG) is a leading cause of morbidity, mortality, and increased length of hospital stay. Many studies have investigated the predictive value of known risk factors for infection in patients following CABG and conclusions have been variable and may reveal regional or institution-specific influence. The purpose of this prospective study was to determine the pre- and peri-operative risk factors for infection in patients undergoing coronary artery bypass surgery in a developing country.
METHODS:
A prospective study was undertaken to collect data on 12 reported risk factors for all patients undergoing CABG during a five-year period at The Aga Khan University Hospital, Pakistan. The relationship of these risk factors to infection following CABG was evaluated.
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/21224817
CONCLUSION:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/21224817 Show less

Munir MB, Malik DS, Khan MT, Schaefle KJ, Argenziano M, Cheema FH. A new pulsatile volumetric device with biomorphic valves for the in vitro study of the cardiovascular system. Artif Organs. 2011 Jan;35(1):96-7. PMID: 21226747

Munir MB, Jiang J, Mehdi MJ, Takayama H, Cheema FH. A novel subcutaneous counterpulsation device: acute hemodynamic efficacy during pharmacologically induced hypertension, hypotension, and heart failure. Artif Organs. 2011 Jan;35(1):92-3. PMID: 21226745

Bisleri G, Cheema FH, Muneretto C. Sternal oozing following cardiac surgery: unusual presentations of left ventricular patch dehiscence. J Card Surg. 2011 Jan;26(1):71. PMID: 21044151

Gao X, Eladari D, Leviel F, Tew BY, Miró-Julià C, Cheema FH, Miller L, Nelson R, Paunescu TG, McKee M, Brown D, Al-Awqati Q. Deletion of hensin/DMBT1 blocks conversion of beta- to alpha-intercalated cells and induces distal renal tubular acidosis. PNAS. 2010 Dec 14;107(50):21872-7. PMID: 21098262

Abstract
Acid-base transport in the renal collecting tubule is mediated by two canonical cell types: the β-intercalated cell secretes HCO(3) by an apical Cl:HCO(3) named pendrin and a… Show more

Gao X, Eladari D, Leviel F, Tew BY, Miró-Julià C, Cheema FH, Miller L, Nelson R, Paunescu TG, McKee M, Brown D, Al-Awqati Q. Deletion of hensin/DMBT1 blocks conversion of beta- to alpha-intercalated cells and induces distal renal tubular acidosis. PNAS. 2010 Dec 14;107(50):21872-7. PMID: 21098262

Abstract
Acid-base transport in the renal collecting tubule is mediated by two canonical cell types: the β-intercalated cell secretes HCO(3) by an apical Cl:HCO(3) named pendrin and a basolateral vacuolar (V)-ATPase. Acid secretion is mediated by the α-intercalated cell, which has an apical V-ATPase and a basolateral Cl:HCO(3) exchanger (kAE1). We previously suggested that the β-cell converts to the α-cell in response to acid feeding, a process that depended on the secretion and deposition of an extracellular matrix protein termed hensin (DMBT1). Here, we show that deletion of hensin from intercalated cells results in the absence of typical α-intercalated cells and the consequent development of complete distal renal tubular acidosis (dRTA). Essentially all of the intercalated cells in the cortex of the mutant mice are canonical β-type cells, with apical pendrin and basolateral or diffuse/bipolar V-ATPase. In the medulla, however, a previously undescribed cell type has been uncovered, which resembles the cortical β-intercalated cell in ultrastructure, but does not express pendrin. Polymerization and deposition of hensin (in response to acidosis) requires the activation of β1 integrin, and deletion of this gene from the intercalated cell caused a phenotype that was identical to the deletion of hensin itself, supporting its critical role in hensin function. Because previous studies suggested that the conversion of β- to α-intercalated cells is a manifestation of terminal differentiation, the present results demonstrate that this differentiation proceeds from HCO(3) secreting to acid secreting phenotypes, a process that requires deposition of hensin in the ECM. Show less

Iribarne A, Russo MJ, Easterwood R, Hong KN, Yang J, Cheema FH, Smith CR, Argenziano M. Minimally invasive versus sternotomy approach for mitral valve surgery: a propensity analysis. Ann Thorac Surg. 2010 Nov;90(5):1471-7. PMID: 20971243

Abstract
BACKGROUND:
Over the past decade, minimally invasive (MI) mitral valve surgery has grown in popularity. The purpose of this study was to compare both short- and long-term outcomes of mitral valve repair and replacement performed through a… Show more

Iribarne A, Russo MJ, Easterwood R, Hong KN, Yang J, Cheema FH, Smith CR, Argenziano M. Minimally invasive versus sternotomy approach for mitral valve surgery: a propensity analysis. Ann Thorac Surg. 2010 Nov;90(5):1471-7. PMID: 20971243

Abstract
BACKGROUND:
Over the past decade, minimally invasive (MI) mitral valve surgery has grown in popularity. The purpose of this study was to compare both short- and long-term outcomes of mitral valve repair and replacement performed through a MI versus traditional sternotomy (ST) incision using a propensity analysis approach to account for differences in baseline risk.
METHODS:
From January 2000 to December 2008, a total of 1,121 isolated mitral valve operations were performed at our institution (548 ST, 573 MI). Data were retrospectively collected on all patients, and a logistic regression model was created to predict selection to a MI versus ST approach. Propensity scores were then generated based on the regression model and matched pairs created using 1:1 nearest neighbor matching. There were 382 matched pairs in the analysis for a total sample size of 764, or 68.2% of the original cohort. Major outcomes of interest included cardiopulmonary bypass time, cross-clamp time, hospital length of stay, major in-hospital complications, and both short- and long-term survival.
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/20971243
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/20971243 Show less

Iribarne A, Easterwood R, Russo MJ, Yang J, Cheema FH, Smith CR, Argenziano M. Long-term outcomes with a minimally invasive approach for resection of cardiac masses. Ann Thorac Surg. 2010 Oct;90(4):1251-5. PMID: 20868822

Abstract
BACKGROUND:
Minimally invasive cardiac surgery has been used with increased frequency in all areas of cardiac surgery. The purpose of this study was to compare the effectiveness of a minimally invasive (MI) versus traditional sternotomy approach for the… Show more

Iribarne A, Easterwood R, Russo MJ, Yang J, Cheema FH, Smith CR, Argenziano M. Long-term outcomes with a minimally invasive approach for resection of cardiac masses. Ann Thorac Surg. 2010 Oct;90(4):1251-5. PMID: 20868822

Abstract
BACKGROUND:
Minimally invasive cardiac surgery has been used with increased frequency in all areas of cardiac surgery. The purpose of this study was to compare the effectiveness of a minimally invasive (MI) versus traditional sternotomy approach for the resection of cardiac masses.
METHODS:
From January 1, 2000 to December 31, 2007, 74 patients (36 traditional sternotomy, 38 MI) underwent surgery for isolated resection of a cardiac mass. Major outcomes of interest included cardiopulmonary bypass time, cross-clamp time, conversion to full median sternotomy, final pathologic diagnosis, tumor-free margins of specimen, length of stay, major in-hospital complications (stroke, renal failure, respiratory failure, reoperation, and infection), and survival. Mean follow-up time was 4.8 years.
RESULTS:
There was no significant difference in cardiopulmonary bypass time or cross-clamp time between groups. No MI cases required conversion to a full median sternotomy, and there was no evidence of new valvular insufficiency on postoperative transesophageal echocardiogram. There was also no difference between traditional sternotomy and MI groups with regard to margins of the resected specimen, nor was there a difference in the size of the resected specimen between groups. Length of stay was shorter in the MI group by 2.2 days (p = 0.044), and the proportion of strokes was also lower in the MI group (p = 0.023). There was no difference in morbidity or mortality between groups.
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/20868822 Show less

Iribarne A, Karpenko A, Russo MJ, Cheema FH, Umann T, Oz MC, Smith CR, Argenziano M. Eight-year experience with minimally invasive cardiothoracic surgery. World J Surg. 2010 Apr;34(4):611-5. PMID: 19838752

Abstract
BACKGROUND:
Over the past decade, minimally invasive cardiac surgery (MICS) has emerged as an accepted approach for the management of cardiac disease that requires a surgical solution. We report the results of an 8-year, single-institution experience with… Show more

Iribarne A, Karpenko A, Russo MJ, Cheema FH, Umann T, Oz MC, Smith CR, Argenziano M. Eight-year experience with minimally invasive cardiothoracic surgery. World J Surg. 2010 Apr;34(4):611-5. PMID: 19838752

Abstract
BACKGROUND:
Over the past decade, minimally invasive cardiac surgery (MICS) has emerged as an accepted approach for the management of cardiac disease that requires a surgical solution. We report the results of an 8-year, single-institution experience with MICS.
METHODS:
Between January 1, 2000 and December 31, 2007, a total of 910 patients underwent MICS. Major cases included aortic valve procedures (71, 7.8%), coronary artery bypass grafting (96, 10.5%), atrioseptal defect repair (103, 11.3%), and mitral valve procedures (507, 55.7%). Major outcomes of interest included the complication and mortality rates.
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/19838752
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/19838752 Show less

Munir MB, Schaefle KJ, Argenziano M, Cheema FH. Letter to the editor Re: First clinical application of the DuraHeart centrifugal ventricular assist device for a Japanese patient. Artif Organs. 2010 Apr;34(4):348. PMID: 20420618

Ahmad M, Topkara VK, Housman B, Argenziano M, Cheema FH. Assessment of a new experimental model of isolated right ventricular failure. Artif Organs. 2010 Mar;34(3):269-70; PMID: 20447053

Uriel N, Vainrib A, Jorde UP, Cotarlan V, Farr M, Cheema FH, Naka Y, Mancini D, Colombo PC. Mediastinal radiation and adverse outcomes after heart transplantation. J Heart Lung Transplant. 2010 Mar;29(3):378-81. PMID: 19804988

Abstract
Orthotopic heart transplantation (OHT) may represent the only treatment option for patients with end-stage cardiovascular disease due to mediastinal radiation therapy (MRT). The primary aim of this study was to evaluate the safety and efficacy of OHT in… Show more

Uriel N, Vainrib A, Jorde UP, Cotarlan V, Farr M, Cheema FH, Naka Y, Mancini D, Colombo PC. Mediastinal radiation and adverse outcomes after heart transplantation. J Heart Lung Transplant. 2010 Mar;29(3):378-81. PMID: 19804988

Abstract
Orthotopic heart transplantation (OHT) may represent the only treatment option for patients with end-stage cardiovascular disease due to mediastinal radiation therapy (MRT). The primary aim of this study was to evaluate the safety and efficacy of OHT in this patient population. We conducted a retrospective, single-center cohort study of patients with MRT-associated cardiovascular disease who underwent OHT between January 1987 and September 2008. Nine patients (3 men), aged 46 +/- 11 years at the time of their OHT, were identified. Time from MRT to OHT was 26 +/- 11 years. Lymphoma was the indication for MRT in all patients. Five patients had non-ischemic dilated cardiomyopathy, 2 had ischemic cardiomyopathy and 2 had constrictive pericarditis. Three patients expired in the peri-operative period, whereas another patient died 3 years post-transplant from lung carcinoma. Two additional patients developed a secondary malignancy post-transplant. Five patients are still alive at a mean follow-up of 10 +/- 8 years. Early survival rate is poor in patients who undergo OHT for MRT-associated end-stage cardiovascular disease. In addition, long-term follow-up shows an elevated incidence of malignancies. Our results raise concern about the safety and efficacy of performing OHT in patients with MRT-associated cardiovascular disease. Show less

Oliver JA, Klinakis A, Cheema FH, Friedlander J, Sampogna RV, Martens TP, Liu C, Efstratiadis A, Al-Awqati Q. Proliferation and migration of label-retaining cells of the kidney papilla. J Am Soc Nephrol. 2009 Nov;20(11):2315-27. PMID: 19762493

Abstract
The kidney papilla contains a population of cells with several characteristics of adult stem cells, including the retention of proliferation markers during long chase periods (i.e., they are label-retaining cells [LRCs]). To determine… Show more

Oliver JA, Klinakis A, Cheema FH, Friedlander J, Sampogna RV, Martens TP, Liu C, Efstratiadis A, Al-Awqati Q. Proliferation and migration of label-retaining cells of the kidney papilla. J Am Soc Nephrol. 2009 Nov;20(11):2315-27. PMID: 19762493

Abstract
The kidney papilla contains a population of cells with several characteristics of adult stem cells, including the retention of proliferation markers during long chase periods (i.e., they are label-retaining cells [LRCs]). To determine whether the papillary LRCs generate new cells in the normal adult kidney, we examined cell proliferation throughout the kidney and found that the upper papilla is a site of enhanced cell cycling. Using genetically modified mice that conditionally expressed green fluorescence protein fused to histone 2B, we observed that the LRCs of the papilla proliferated only in its upper part, where they associate with "chains" of cycling cells. The papillary LRCs decreased in number with age, suggesting that the cells migrated to the upper papilla before entering the cell cycle. To test this directly, we marked papillary cells with vital dyes in vivo and found that some cells in the kidney papilla, including LRCs, migrated toward other parts of the kidney. Acute kidney injury enhanced both cell migration and proliferation. These results suggest that during normal homeostasis, LRCs of the kidney papilla (or their immediate progeny) migrate to the upper papilla and form a compartment of rapidly proliferating cells, which may play a role in repair after ischemic injury. Show less

Agrifoglio M, Barili F, Dainese L, Cappai A, Cheema FH, Biglioli P. An occasional diagnosis of myasthenia gravis--a focus on thymus during cardiac surgery: a case report. J Cardiothorac Surg. 2009 Oct 7;4:55. PMID: 19811646

Abstract
BACKGROUND:
Myasthenia gravis, an uncommon autoimmune syndrome, is commonly associated with thymus abnormalities. Thymomatous myasthenia gravis is considered to have worst prognosis and thymectomy can reverse symptoms if precociously performed.
CASE… Show more

Agrifoglio M, Barili F, Dainese L, Cappai A, Cheema FH, Biglioli P. An occasional diagnosis of myasthenia gravis--a focus on thymus during cardiac surgery: a case report. J Cardiothorac Surg. 2009 Oct 7;4:55. PMID: 19811646

Abstract
BACKGROUND:
Myasthenia gravis, an uncommon autoimmune syndrome, is commonly associated with thymus abnormalities. Thymomatous myasthenia gravis is considered to have worst prognosis and thymectomy can reverse symptoms if precociously performed.
CASE REPORT:
We describe a case of a patient who underwent mitral valve repair and was found to have an occasional thymomatous mass during the surgery. A total thymectomy was performed concomitantly to the mitral valve repair.
CONCLUSION:
The diagnosis of thymomatous myasthenia gravis was confirmed postoperatively. Following the surgery this patient was strictly monitored and at 1-year follow-up a complete stable remission had been successfully achieved. Show less

Aziz F, Magda G, Cheema FH. Re: Cardiorespiratory, metabolic, and biomechanical responses during functional electrical stimulation leg exercise: health and fitness benefits. Artif Organs. 2009 Apr;33(4):387. PMID: 19335416

Cheema FH, Weisberg JS, Khalid I, Roberts HG Jr. Warm beating heart, robotic endoscopic Cox-cryomaze: an approach for treating atrial fibrillation. Ann Thorac Surg. 2009 Mar;87(3):966-8. PMID: 19231444

Abstract
With recent technological advancements, an increasing number of minimally invasive approaches are being explored as potential alternatives to the traditional cut-and-sew Cox maze III for treating atrial fibrillation. We describe an approach for treating atrial fibrillation that… Show more

Cheema FH, Weisberg JS, Khalid I, Roberts HG Jr. Warm beating heart, robotic endoscopic Cox-cryomaze: an approach for treating atrial fibrillation. Ann Thorac Surg. 2009 Mar;87(3):966-8. PMID: 19231444

Abstract
With recent technological advancements, an increasing number of minimally invasive approaches are being explored as potential alternatives to the traditional cut-and-sew Cox maze III for treating atrial fibrillation. We describe an approach for treating atrial fibrillation that consists of a warm beating heart, robotic endoscopic Cox-cryomaze with a full set of left atrial argon-based cryolesions. Show less

Kanwal S, Singh J, Malik N, Cheema FH, Khalid I. Development of a composite degradable/nondegradable tissue-engineered vascular graft. Artif Organs. 2009 Feb;33(2):194. PMID: 19178468

Barili F, Dainese L, Cheema FH, Argenziano M, Locatelli A, Grossi C. Bioengineering of the aortic valve: a race without a finish line. Artif Organs. 2009 Jan;33(1):86-7. PMID: 19178447

Kanwal S, Malik N, Singh J, Khalid I, Cheema FH. Re: Hydrogel-based engineered skeletal muscle grafts normalize heart function early after myocardial infarction. Artif Organs. 2009 Jan;33(1):87. PMID: 19178449

Kanwal S, Malik NM, Cheema FH. Innovative, replaceable heart valve: concept, in vitro study, and acute in vivo study. Artif Organs. 2008 Dec;32(12):999. PMID: 19133033

Cayci C, Russo M, Cheema FH, Martens T, Ozcan V, Argenziano M, Oz MC, Ascherman J. Risk analysis of deep sternal wound infections and their impact on long-term survival: a propensity analysis. Ann Plast Surg. 2008 Sep;61(3):294-301. PMID: 18724131

Abstract
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/18724131

Osorio JC, Cheema FH, Martens TP, Mahmut N, Kinnear C, Gonzalez AM, Bonney W, Homma S, Liao JK, Mital S. Simvastatin reverses cardiac hypertrophy caused by disruption of the bradykinin 2 receptor. Can J Physiol Pharmacol. 2008 Sep;86(9):633-42. PMID: 18758513

Abstract
Bradykinin 2 receptor (B2R) deficiency predisposes to cardiac hypertrophy and hypertension. The pathways mediating these effects are not known. Two-month-old B2R knockout (KO) and wild-type (WT) mice were assigned to 4… Show more

Osorio JC, Cheema FH, Martens TP, Mahmut N, Kinnear C, Gonzalez AM, Bonney W, Homma S, Liao JK, Mital S. Simvastatin reverses cardiac hypertrophy caused by disruption of the bradykinin 2 receptor. Can J Physiol Pharmacol. 2008 Sep;86(9):633-42. PMID: 18758513

Abstract
Bradykinin 2 receptor (B2R) deficiency predisposes to cardiac hypertrophy and hypertension. The pathways mediating these effects are not known. Two-month-old B2R knockout (KO) and wild-type (WT) mice were assigned to 4 treatment groups (n = 12-14/group): control (vehicle); nitro-L-arginine methyl ester (L-NAME) an NO synthase inhibitor; simvastatin (SIM), an NO synthase activator; and SIM+L-NAME. Serial echocardiography was performed and blood pressure (BP) at 6 weeks was recorded using a micromanometer. Myocardial eNOS and mitogen-activated protein kinase (MAPK, including ERK, p38, and JNK) protein expression were measured. Results showed that (i) B2RKO mice had significantly lower ejection fraction than did WT mice (61% +/- 1% vs. 73% +/- 1%), lower myocardial eNOS and phospho-eNOS, normal systolic BP, and higher LV mass, phospho-p38, and JNK; (ii) L-NAME increased systolic BP in KO mice (117 +/- 19 mm Hg) but not in WT mice and exacerbated LV hypertrophy and dysfunction; and (iii) in KO mice, SIM decreased hypertrophy, p38, and JNK, improved function, increased capillary eNOS and phospho-eNOS, and prevented L-NAME-induced LV hypertrophy without lowering BP. We conclude that disruption of the B2R causes maladaptive cardiac hypertrophy with myocardial eNOS downregulation and MAPK upregulation. SIM reverses these abnormalities and prevents the development of primary cardiac hypertrophy as well as hypertrophy secondary to L-NAME-induced hypertension. Show less

Imren Y, Tasoglu I, Oktar GL, Benson A, Naseem T, Cheema FH, Unal Y. The importance of transesophageal echocardiography in diagnosis of pericardial tamponade after cardiac surgery. J Card Surg. 2008 Sep-Oct;23(5):450-3. PMID: 18462344

Abstract
BACKGROUND AND AIM OF THE STUDY:
Despite the fact that there is a simple and effective treatment for pericardial tamponade (PCT), delayed diagnosis can cause serious morbidities or even mortality. In this study, we discuss the management and… Show more

Imren Y, Tasoglu I, Oktar GL, Benson A, Naseem T, Cheema FH, Unal Y. The importance of transesophageal echocardiography in diagnosis of pericardial tamponade after cardiac surgery. J Card Surg. 2008 Sep-Oct;23(5):450-3. PMID: 18462344

Abstract
BACKGROUND AND AIM OF THE STUDY:
Despite the fact that there is a simple and effective treatment for pericardial tamponade (PCT), delayed diagnosis can cause serious morbidities or even mortality. In this study, we discuss the management and the diagnostic procedures of PCT.
MATERIALS AND METHODS:
Sixty-two patients with suspected PCT were initially evaluated with transthoracic echocardiography (TTE) and then with transesophageal echocardiography (TEE). Forty-nine (79%) patients were chosen for surgery after TEE displayed a suspected PCT diagnosis. Patients with suspected PCT were divided into two groups: Early-phase PCT (symptoms developed within 72 hours) and late-phase PCT (symptoms developed after 72 hours).
RESULTS:
Thirty-five (56%) patients were in the early phase and 27 (44%) patients were in the late phase. In 13 out of 22 (59%) cases, from both early and late phases, TTE findings showed no PCT, but TEE findings showed a positive PCT diagnosis. All 13 of the cases where TEE was positive after a negative TTE were confirmed by surgery. Overall, the PCT diagnoses in 48 out of 49 patients were confirmed during surgery.
DISCUSSION:
The role of echocardiography in PCT diagnosis is shown to be extremely important in some clinical cases, such as in patients during the postoperative period after cardiac surgery. Furthermore, particularly when TTE does not provide complete imaging of the pericardial sac, TEE should be mandatory. We recommend that even patients with a negative diagnosis of PCT from TTE should undergo further evaluation with TEE. Show less

Agrifoglio M, Trezzi M, Barili F, Dainese L, Cheema FH, Topkara VK, Ghislandi C, Parolari A, Polvani G, Alamanni F, Biglioli P. Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate. J Cardiothorac Surg. 2008 Jun 23;3:35. PMID: 18573201

Abstract
BACKGROUND:
The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with… Show more

Agrifoglio M, Trezzi M, Barili F, Dainese L, Cheema FH, Topkara VK, Ghislandi C, Parolari A, Polvani G, Alamanni F, Biglioli P. Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate. J Cardiothorac Surg. 2008 Jun 23;3:35. PMID: 18573201

Abstract
BACKGROUND:
The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia.
METHODS:
81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay.
RESULTS:
Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 +/- 2.1 and 7.3 +/- 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 +/- 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02-1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI.
CONCLUSION:
CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control. Show less

Imren Y, Benson AA, Oktar GL, Cheema FH, Comas G, Naseem T. Is use of temporary pacing wires following coronary bypass surgery really necessary? J Cardiovasc Surg (Torino). 2008 Apr;49(2):261-7. PMID: 18431348

Abstract
AIM:
Temporary epicardial pacing wires (TEPW) which are routinely used after coronary bypass grafting may result in significant complications. We sought to identify variables that predict TEPW implantation and thereby limit their use.
METHODS:
This prospective… Show more

Imren Y, Benson AA, Oktar GL, Cheema FH, Comas G, Naseem T. Is use of temporary pacing wires following coronary bypass surgery really necessary? J Cardiovasc Surg (Torino). 2008 Apr;49(2):261-7. PMID: 18431348

Abstract
AIM:
Temporary epicardial pacing wires (TEPW) which are routinely used after coronary bypass grafting may result in significant complications. We sought to identify variables that predict TEPW implantation and thereby limit their use.
METHODS:
This prospective study enrolled 564 patients (296 underwent coronary artery bypass grafting with cardiopulmonary bypass [ONCAB] and 268 underwent off-pump coronary artery bypass grafting, OPCAB). TEPW were placed in patients with the intraoperative presence of one or more of the following criteria: sinus bradycardia, sinus arrest, nodal/junctional rhythms, atrioventricular block, bundle branch block, ventricular tachycardia, or onset of atrial fibrillation.
RESULTS:
Only 31 (5.5%) patients [ONCAB: 20 (6.8%) (ventricular: 14, bichamber: 6); OPCAB: 11 (4.1%) (ventricular: 9, bichamber: 2)] had temporary epicardial pacing wires implanted intraoperatively. Indications for using temporary epicardial pacing wires for ONCAB were sinus bradycardia (8), nodal/junctional rhythms (3), atrioventricular block (3), atrial fibrillation (4), and bundle branch block (2), and for OPCAB were sinus bradycardia (8), nodal/junctional rhythms (2), and atrioventricular block (1). Mean duration for pacing was 22.4 h for the ONCAB group and 11.3 h for the OPCAB group. There were no temporary epicardial pacing wires associated complications. One paced OPCAB patient required a permanent pacemaker and 2 non-paced OPCAB patients required transvenous pacing wires. Univariate and multivariate analyses were also conducted to determine risk factors for TEPW.
CONCLUSION:
TEPW implantation is overused in cardiac surgery and by identifying independent predictors for pacing we conclude that TEPW use should be limited to a select few. Show less

Gray EN, Cheema FH. Re: Transfusion protocol for implantation and explantation of cardiac devices in an Academic Medical Center. ASAIO J. 2008 Jan-Feb;54(1):138. PMID: 18204332

Khan F, Khalid I, Cheema FH. Pre-operative renal function and selective renal vein renin levels as markers of favourable outcome in renovascular hypertension. J Pak Med Assoc. 2007 Nov;57(11):575. PMID: 18062531

Barili F, Polvani G, Topkara VK, Dainese L, Cheema FH, Roberto M, Naliato M, Parolari A, Alamanni F, Biglioli P. Role of hyperbaric oxygen therapy in the treatment of postoperative organ/space sternal surgical site infections. World J Surg. 2007 Aug;31(8):1702-6. PMID: 17551783

Abstract
BACKGROUND:
A prospective trial was designed to evaluate the effect of hyperbaric oxygen (HBO) therapy on organ/space sternal surgical site infections (SSIs) following cardiac surgery that requires… Show more

Barili F, Polvani G, Topkara VK, Dainese L, Cheema FH, Roberto M, Naliato M, Parolari A, Alamanni F, Biglioli P. Role of hyperbaric oxygen therapy in the treatment of postoperative organ/space sternal surgical site infections. World J Surg. 2007 Aug;31(8):1702-6. PMID: 17551783

Abstract
BACKGROUND:
A prospective trial was designed to evaluate the effect of hyperbaric oxygen (HBO) therapy on organ/space sternal surgical site infections (SSIs) following cardiac surgery that requires sternotomy.
METHODS:
A total of 32 patients who developed postoperative organ/space sternal SSI were enrolled in this study from 1999 through 2005. All patients were offered HBO therapy. Group 1 included the patients who accepted and were able to undergo HBO therapy (n = 14); group 2 included patients who refused HBO therapy or had contraindications to it (n = 18).
RESULTS:
The two groups were well matched at baseline with comparable preoperative clinical characteristics and operative factors. Staphylococcus was the most common pathogen for both groups. The duration of infection was similar in groups 1 and 2 (31.8 7.6 vs. 29.3 5.7 days, respectively, p = 0.357). The infection relapse rate was significantly lower in group 1 (0% vs. 33.3%, p = 0.024). Moreover, the duration of intravenous antibiotic use (47.8 +/- 7.4 vs. 67.6 +/- 25.1 days, p = 0.036) and total hospital stay (52.6 +/- 9.1 vs. 73.6 +/- 24.5 days, p = 0.026) were both significantly shorter in group 1.
CONCLUSION:
Hyperbaric oxygen is a valuable addition to the armamentarium available to physicians for treating postoperative organ/space sternal SSI. Show less

Schulman AR, Martens TP, Christos PJ, Russo MJ, Comas GM, Cheema FH, Naseem TM, Wang R, Idrissi KA, Bailey SH, Naka Y. Comparisons of infection complications between continuous flow and pulsatile flow left ventricular assist devices. J Thorac Cardiovasc Surg. 2007 Mar;133(3):841-2. PMID: 17320612

Bardakci H, Cheema FH, Topkara VK, Dang NC, Martens TP, Mercando ML, Forster CS, Benson AA, George I, Russo MJ, Oz MC, Esrig BC. Discharge to home rates are significantly lower for octogenarians undergoing coronary artery bypass graft surgery. Ann Thorac Surg. 2007 Feb;83(2):483-9. PMID: 17257973

Abstract
BACKGROUND:
The incidence of coronary artery bypass graft surgery (CABG) performed in elderly patients has been increasing over recent years. We sought to evaluate clinical… Show more

Bardakci H, Cheema FH, Topkara VK, Dang NC, Martens TP, Mercando ML, Forster CS, Benson AA, George I, Russo MJ, Oz MC, Esrig BC. Discharge to home rates are significantly lower for octogenarians undergoing coronary artery bypass graft surgery. Ann Thorac Surg. 2007 Feb;83(2):483-9. PMID: 17257973

Abstract
BACKGROUND:
The incidence of coronary artery bypass graft surgery (CABG) performed in elderly patients has been increasing over recent years. We sought to evaluate clinical outcomes of octogenarians undergoing CABG using an audited state-wide mandatory database.
METHODS:
New York State Department of Health's Cardiac Reporting System was analyzed from 1998 to 2002. In all, 88,154 patients undergoing isolated CABG were identified. Patients were divided into four age groups: less than 50 years (group 1, n = 6,527), 50 to 64 years (group 2, n = 30,088), 65 to 79 years (group 3, n = 43,369), and 80 years and above (group 4, n = 8,170).
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/17257973
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/17257973 Show less

Barili F, Dainese L, Cheema FH, Dell'Antonio G, Topkara VK, Rossoni G, Guarino A, Micheli B, Doglioni C, Biglioli P, Polvani G. Rates of cycling cells in cryopreserved valvular homograft: a preliminary study. Artif Organs. 2007 Feb;31(2):152-4. PMID: 17298405

Abstract
Some investigators claim that the viability of cryopreserved human valvular homograft is necessary for the duration of implanted homograft. In this preliminary study, the percentage of cycling cells in cryopreserved… Show more

Barili F, Dainese L, Cheema FH, Dell'Antonio G, Topkara VK, Rossoni G, Guarino A, Micheli B, Doglioni C, Biglioli P, Polvani G. Rates of cycling cells in cryopreserved valvular homograft: a preliminary study. Artif Organs. 2007 Feb;31(2):152-4. PMID: 17298405

Abstract
Some investigators claim that the viability of cryopreserved human valvular homograft is necessary for the duration of implanted homograft. In this preliminary study, the percentage of cycling cells in cryopreserved valvular homografts was evaluated with the use of monoclonal Ki-67 antibody. Three human aortic valves were harvested from multiorgan donors and cryopreserved. Sections of 5 microm in thickness were stained with monoclonal Ki-67 antibody. The proportion of endothelial cells with Ki-67 positive nuclei was 1.80 +/- 0.20%. No differences in distribution were observed from basal to marginal sites. Few fibroblasts showed Ki-67-immunopositivity (0.10 +/- 0.06%) while the Ki-67 immunostaining was 0.80 +/- 0.20% in myocytes. Our preliminary study shows that cryopreserved valvular homograft cells are not only viable but they also have the potential to replicate. These data can lead to the hypothesis that valvular cells could actively replicate even after implantation, permitting cellular renewal and regeneration of extracellular matrix's components. Show less

Russo MJ, Chen JM, Sorabella RA, Martens TP, Garrido M, Davies RR, George I, Cheema FH, Mosca RS, Mital S, Ascheim DD, Argenziano M, Stewart AS, Oz MC, Naka Y. The effect of ischemic time on survival after heart transplantation varies by donor age: an analysis of the United Network for Organ Sharing database. J Thorac Cardiovasc Surg. 2007 Feb;133(2):554-9. PMID: 17258599

Abstract
OBJECTIVES:
(1) To examine the interaction of donor age with ischemic time and their effect on… Show more

Russo MJ, Chen JM, Sorabella RA, Martens TP, Garrido M, Davies RR, George I, Cheema FH, Mosca RS, Mital S, Ascheim DD, Argenziano M, Stewart AS, Oz MC, Naka Y. The effect of ischemic time on survival after heart transplantation varies by donor age: an analysis of the United Network for Organ Sharing database. J Thorac Cardiovasc Surg. 2007 Feb;133(2):554-9. PMID: 17258599

Abstract
OBJECTIVES:
(1) To examine the interaction of donor age with ischemic time and their effect on survival and (2) to define ranges of ischemic time associated with differences in survival.
METHODS:
The United Network for Organ Sharing provided de-identified patient-level data. The study population included 33,640 recipients undergoing heart transplantation between October 1, 1987, and December 31, 2004. Recipients were divided by donor age into terciles: 0 to 19 years (n = 10,814; 32.1%), 20 to 33 years (11,410, 33.9%), and 34 years or more (11,416, 33.9%). Kaplan-Meier survival functions and Cox regression were used for time-to-event analysis. Receiver operating characteristic curves and stratum-specific likelihood ratios were generated to compare 5-year survival at various thresholds for ischemic time.
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/17258599
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/17258599 Show less

Barili F, Polvani G, Topkara VK, Dainese L, Roberto M, Aljaber E, Bettoni M, Cheema FH, Trabattuni P, Parolapi A, Spirito R, Biglioli P. Administration of octreotide for management of postoperative high-flow chylothorax. Ann Vasc Surg. 2007 Jan;21(1):90-2. PMID: 17349344

Abstract
Chylothorax is a rare complication of adult cardiothoracic surgery that can affect the postoperative course as it can lead to respiratory insufficiency, protein loss, fluid imbalance, and immunodeficiency. We… Show more

Barili F, Polvani G, Topkara VK, Dainese L, Roberto M, Aljaber E, Bettoni M, Cheema FH, Trabattuni P, Parolapi A, Spirito R, Biglioli P. Administration of octreotide for management of postoperative high-flow chylothorax. Ann Vasc Surg. 2007 Jan;21(1):90-2. PMID: 17349344

Abstract
Chylothorax is a rare complication of adult cardiothoracic surgery that can affect the postoperative course as it can lead to respiratory insufficiency, protein loss, fluid imbalance, and immunodeficiency. We report the case of a 51-year-old man who developed a persistent high-flow chylothorax after replacement of the descending thoracic aorta for an aneurysm. After a week of complete oral intake cessation and total parenteral nutrition, we started administration of octreotide, a somatostatin analog. It led to rapid cessation of chyle production, and the patient was discharged without further complications and chylothorax relapses. Show less

Russo MJ, Davies RR, Sorabella RA, Martens TP, George I, Cheema FH, Mital S, Mosca RS, Chen JM. Adult-age donors offer acceptable long-term survival to pediatric heart transplant recipients: an analysis of the United Network of Organ Sharing database. J Thorac Cardiovasc Surg. 2006 Nov;132(5):1208-12. PMID: 17059945

Abstract
OBJECTIVES:
A critical shortage of donor organs has caused many centers to use less restrictive donor criteria, including the use of adult-age donors for… Show more

Russo MJ, Davies RR, Sorabella RA, Martens TP, George I, Cheema FH, Mital S, Mosca RS, Chen JM. Adult-age donors offer acceptable long-term survival to pediatric heart transplant recipients: an analysis of the United Network of Organ Sharing database. J Thorac Cardiovasc Surg. 2006 Nov;132(5):1208-12. PMID: 17059945

Abstract
OBJECTIVES:
A critical shortage of donor organs has caused many centers to use less restrictive donor criteria, including the use of adult-age donors for pediatric recipients. The purpose of this study is (1) to describe the supply of pediatric (0-18 years) heart donors, (2) to explore the relationship between donor age and long-term survival, and (3) to define threshold age ranges associated with decreased long-term survival.
METHODS:
The United Network of Organ Sharing provided deidentified patient-level data. Primary analysis focused on 1887 heart transplant recipients aged 9 to 18 years undergoing transplantation from October 1, 1987, to September 25, 2005. Kaplan-Meier analysis and log-rank tests were used in time-to-event analysis. Receiver operating characteristic curves and stratum-specific likelihood ratios were generated to compare survival at various donor age thresholds.
RESULTS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/17059945
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/17059945 Show less

Topkara VK, Williams MR, Cheema FH, Vigilance DW, Garrido MJ, Russo MJ, Oz MC, Argenziano M. Surgical ablation of atrial fibrillation: the Columbia Presbyterian experience. J Card Surg. 2006 Sep-Oct;21(5):441-8. PMID: 16948752

Abstract
BACKGROUND:
The Maze III procedure is an effective surgical treatment for atrial fibrillation (AF). However, it is not widely applied due to its complexity, increased operative times, and the risk of bleeding. Various energy sources have been… Show more

Topkara VK, Williams MR, Cheema FH, Vigilance DW, Garrido MJ, Russo MJ, Oz MC, Argenziano M. Surgical ablation of atrial fibrillation: the Columbia Presbyterian experience. J Card Surg. 2006 Sep-Oct;21(5):441-8. PMID: 16948752

Abstract
BACKGROUND:
The Maze III procedure is an effective surgical treatment for atrial fibrillation (AF). However, it is not widely applied due to its complexity, increased operative times, and the risk of bleeding. Various energy sources have been introduced to simplify the traditional "cut and sew" approach.
METHODS:
This study involves patients undergoing surgical atrial fibrillation ablation (SAFA) at a single institution from 1999 to 2005. Type of concomitant procedures, preoperative clinical characteristics, and chronicity of AF were evaluated in overall patient population. Parameters including surgical approach, lesion pattern, and energy source used were collected intraoperatively. Clinical outcomes examined were postoperative rhythm success, stroke, early mortality, and long-term survival.
RESULTS:
Three hundred thirty-nine patients were identified. Three hundred twenty-eight (96.8%) patients had associated cardiac disease and underwent concomitant procedures; 75.8% of patients had persistent AF. Energy sources used were microwave (49.8%), radiofrequency (42.2%), and laser (8.0%). In 41.9% of cases a pulmonary vein encircling lesion was the only lesion created. Combination lesion sets were performed in the remaining cases. Rhythm success rates at 3, 6, 12, and 24 months were 74.1%, 68.2%, 74.5%, and 71.1%, respectively. Patients who underwent surgical removal of left atrial appendage by means of stapling or simple excision had no early postoperative stroke. Early mortality was 4.9%. Postoperative survival rates at 1, 3, and 5 years were 89.6%, 83.1%, and 78.0%.
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/16948752 Show less

Polvani G, Barili F, Dainese L, Topkara VK, Cheema FH, Penza E, Ferrarese S, Parolari A, Alamanni F, Biglioli P. Reduction ascending aortoplasty: midterm follow-up and predictors of redilatation. Ann Thorac Surg. 2006 Aug;82(2):586-91. PMID: 16863769

Abstract
BACKGROUND:
Reduction ascending aortoplasty is an alternative procedure to the replacement of the ascending aorta in case of ascending aorta aneurysm without aortic root involvement. This study was designed to evaluate the… Show more

Polvani G, Barili F, Dainese L, Topkara VK, Cheema FH, Penza E, Ferrarese S, Parolari A, Alamanni F, Biglioli P. Reduction ascending aortoplasty: midterm follow-up and predictors of redilatation. Ann Thorac Surg. 2006 Aug;82(2):586-91. PMID: 16863769

Abstract
BACKGROUND:
Reduction ascending aortoplasty is an alternative procedure to the replacement of the ascending aorta in case of ascending aorta aneurysm without aortic root involvement. This study was designed to evaluate the midterm follow-up of aortoplasty and to determine predictors of redilatation.
METHODS:
From January 1, 1998, to April 30, 2005, 68 patients with dilatation of the ascending aorta underwent unsupported reduction aortoplasty in combination with other cardiac procedures. All patients underwent associated surgical procedures. Sixty patients (88.2%) underwent associated aortic valve replacement. Cumulative follow-up time was 191.4 patient-years and was 100% complete. Median follow-up time was 2.5 years, and mean follow-up time was 2.9 +/- 1.7 years (range, 0.4 to 6.3 years).
RESULTS:
The overall perioperative mortality rate was 1.5%. Overall survival estimates at 3 and 6 years were 93.3% +/- 4.5% and 89.3% +/- 5.9%, respectively. The actuarial freedom from cardiac-related death at 3 and 6 years was 100% and 95.7% +/- 4.3%, respectively. Ascending aorta redilatation occurred in 5 patients (7.5%). The actuarial freedom from redilatation at 3 and 6 years was 97.7% +/- 2.3% and 79.8% +/- 8.4%, respectively. The actuarial freedom from reoperation at 3 and 6 years was 100% and 86.3% +/- 7.5%, respectively. Only preoperative diameter was a significant predictor of redilatation using multivariate stepwise logistic regression analysis.
CONCLUSIONS:
Unsupported reduction aortoplasty is a safe and effective technique with low mortality, low morbidity, and rare late complications for selected chronic aneurysm of the ascending aorta with diameter less than 55 mm. Show less

Topkara VK, Dang NC, Barili F, Martens TP, George I, Cheema FH, Bardakci H, Ozcan AV, Naka Y. Ventricular assist device use for the treatment of acute viral myocarditis. J Thorac Cardiovasc Surg. 2006 May;131(5):1190-1. PMID: 16678619

Dainese L, Barili F, Topkara VK, Cheema FH, Formato M, Aljaber E, Fusari M, Micheli B, Guarino A, Biglioli P, Polvani G. Effect of cryopreservation techniques on aortic valve glycosaminoglycans. Artif Organs. 2006 Apr;30(4):259-64. PMID: 16643384

Abstract

This study was designed to evaluate the effect of cryopreservation on the glycosaminoglycan (GAG) content of the aortic allografts. Twenty-one porcine aortic valves were obtained. Five aortic roots were immediately analyzed… Show more

Dainese L, Barili F, Topkara VK, Cheema FH, Formato M, Aljaber E, Fusari M, Micheli B, Guarino A, Biglioli P, Polvani G. Effect of cryopreservation techniques on aortic valve glycosaminoglycans. Artif Organs. 2006 Apr;30(4):259-64. PMID: 16643384

Abstract

This study was designed to evaluate the effect of cryopreservation on the glycosaminoglycan (GAG) content of the aortic allografts. Twenty-one porcine aortic valves were obtained. Five aortic roots were immediately analyzed without cryopreservation, eight were cryopreserved in closed leaflet position, and eight in open leaflet position. The groups were compared in terms of GAG concentration and subclass proportion in three different zones including the aortic root wall, the commissures, and the leaflets. GAG content at the commissures was significantly lower in the closed leaflet group than in the other groups (P = 0.001). The electrophoretic analysis did not show any significant difference in the zonal distribution of GAG classes between groups. Quantitative analysis in various aortic valve zones suggests that cryopreservation can alter the GAG content. Cryopreservation of the aortic valve in an open leaflet position can preserve the matrix more efficiently and might prolong the durability of the aortic allograft. Show less

Topkara VK, Dang NC, Barili F, Cheema FH, Martens TP, George I, Bardakci H, Oz MC, Naka Y. Predictors and outcomes of continuous veno-venous hemodialysis use after implantation of a left ventricular assist device. J Heart Lung Transplant. 2006 Apr;25(4):404-8. Epub 2006 Feb 28. PMID: 16563969

Abstract
BACKGROUND:
Post-operative renal failure is a common complication after left ventricular assist device (LVAD) implantation. This study was designed to evaluate predictors and outcomes… Show more

Topkara VK, Dang NC, Barili F, Cheema FH, Martens TP, George I, Bardakci H, Oz MC, Naka Y. Predictors and outcomes of continuous veno-venous hemodialysis use after implantation of a left ventricular assist device. J Heart Lung Transplant. 2006 Apr;25(4):404-8. Epub 2006 Feb 28. PMID: 16563969

Abstract
BACKGROUND:
Post-operative renal failure is a common complication after left ventricular assist device (LVAD) implantation. This study was designed to evaluate predictors and outcomes of acute renal failure after LVAD insertion.
METHODS:
Two-hundred one patients undergoing LVAD implantation at a single institution from June 1996 through April 2004 were retrospectively analyzed. Patients were categorized into 2 groups: those who required post-operative continuous veno-venous hemodialysis (CVVHD) (Group 1, n = 65, 32.3%) and those who did not (Group 2, n = 136, 67.7%). Independent predictors of post-operative renal failure requiring CVVHD were determined using multivariate logistic regression techniques.
RESULTS:
Patients who had post-operative renal failure requiring CVVHD were older (53.7 +/- 12.9 vs 48.2 +/- 14.2 years, p = 0.009), had a higher incidence of intra-aortic balloon pump use (46.6% vs 26.2%, p = 0.006), and had a higher pre-operative mean LVAD score (5.8 +/- 3.5 vs 3.8 +/- 3.3, p = 0.001) than those without renal failure. LVAD score was the only independent predictor of post-operative renal failure requiring CVVHD (odds ratio = 1.226, p = 0.006). Sepsis rate was higher (33.3% vs 6.9%, p < 0.001) and bridge-to-transplantation rate was lower (52.4% vs 83.5%, p < 0.001) in Group 1 than in Group 2. Post-LVAD survival rates at 1, 3, 5 and 7 years for Group 1 and Group 2 were 43.2%, 39.1%, 34.7% and 34.7% vs 79.2%, 74.0%, 68.3% and 66.4%, respectively (log rank, p < 0.001).
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/16563969 Show less

Topkara VK, Cheema FH, Kesavaramanujam S, Mercando ML, Forster CS, Argenziano M, Esrig BC, Oz MC, Naka Y. Effect of donor age on long-term survival following cardiac transplantation. J Card Surg. 2006 Mar-Apr;21(2):125-9. PMID: 16492267

Abstract

BACKGROUND AND AIM:
The current shortage of donor hearts has forced the criteria of organ procurement to be extended, leading to increased use of older donor hearts to bridge the gap between demand and availability. Our objective was to… Show more

Topkara VK, Cheema FH, Kesavaramanujam S, Mercando ML, Forster CS, Argenziano M, Esrig BC, Oz MC, Naka Y. Effect of donor age on long-term survival following cardiac transplantation. J Card Surg. 2006 Mar-Apr;21(2):125-9. PMID: 16492267

Abstract

BACKGROUND AND AIM:
The current shortage of donor hearts has forced the criteria of organ procurement to be extended, leading to increased use of older donor hearts to bridge the gap between demand and availability. Our objective was to analyze the effect of donor age on outcomes after cardiac transplantation.
METHODS:
We retrospectively studied 864 patients who underwent cardiac transplantation at New York Presbyterian Hospital - Columbia University between 1992 and 2002. Patients were divided into two groups; donor age <40 years (Group A, n = 600) and donor age > or =40 years (Group B, n = 264).
RESULTS:
Characteristics including gender, body mass index, and cytomegalovirus (CMV) status were significantly different between the two donor age groups. Race, CMV status, toxoplasmosis status, left ventricular assist device prior to transplant, diabetes mellitus, and retransplantation were similar in both the recipient groups, while age, gender, and BMI were different. Early mortality was lower in Group A, 5%, versus 9.5% in Group B. Multivariate analysis revealed recipient female gender (odd ratio (OR) = 1.71), retransplantation (OR = 1.63), and increased donor age (OR = 1.02) as significant predictors of poor survival in the recipient population. Actuarial survival at 1 year (86.7% vs 81%), 5 years (75% vs 65%), and 10 years (56% vs 42%) was significantly different as well with a log rank p = 0.002.
CONCLUSIONS:
These findings suggest that increased donor age is an independent predictor of long-term survival. However, the shortage of organs makes it difficult to follow strict guidelines when placing hearts; therefore, decisions need to be made on a relative basis. Show less

Cheema FH, Colman DL, Martens TP, Topkara VK. Digital recording of operations. Ann Thorac Surg. 2006 Jan;81(1):408-9. PMID: 16368429

Lima B, Kherani AR, Hata JA, Cheema FH, Casher J, Oz MC, Rao V, Fal JM, Chen JM, Morgan JA, Vigilance DW, Garrido MJ, Milano CA, Naka Y. Does a pre-left ventricular assist device screening score predict long-term transplantation success? A 2-center analysis. Heart Surg Forum. 2006;9(5):E783-5. PMID: 17099972

Abstract
BACKGROUND:
A risk factor summation score was previously validated to successfully predict survival after insertion of a left ventricular assist device (LVAD). We… Show more

Lima B, Kherani AR, Hata JA, Cheema FH, Casher J, Oz MC, Rao V, Fal JM, Chen JM, Morgan JA, Vigilance DW, Garrido MJ, Milano CA, Naka Y. Does a pre-left ventricular assist device screening score predict long-term transplantation success? A 2-center analysis. Heart Surg Forum. 2006;9(5):E783-5. PMID: 17099972

Abstract
BACKGROUND:
A risk factor summation score was previously validated to successfully predict survival after insertion of a left ventricular assist device (LVAD). We investigated whether this scoring system also predicts clinical outcomes after eventual heart transplantation in LVAD recipients.
METHODS:
A retrospective review was performed on 153 consecutive patients who received an LVAD as a bridge to transplantation at 2 large-volume centers from 1996 to 2003. The scoring system was used to designate low- and high-scoring groups.
RESULTS:
Thirty-day mortality and 5-year survival after transplantation were equivalent between groups (4.46% versus 7.32% and 76% versus 70%, respectively). No difference was seen in length of posttransplantation ventilator dependence (2.83 +/- 0.49 versus 3.3 +/- 0.72 days) or intensive care unit monitoring (6.38 +/- 0.77 versus 6.97 +/- 1.1 days). However, low-scoring patients had a significantly decreased duration of inotrope support (5.57 +/- 0.45 versus 7.74 +/- 1.0 days, P = .035).
CONCLUSION:
A risk factor summation score may predict which LVAD patients will require prolonged inotropic support following heart transplantation. However, survival in high-risk (elevated score) LVAD patients following heart transplantation is comparable to low-risk groups, favoring the continued practice of LVAD implantation as a bridge to transplantation even in high-risk patients. Show less

Topkara VK, Dang NC, Martens TP, Cheema FH, Liu JF, Liang LM, Cheema AF, Barili F, Oz MC, Naka Y. Effect of diabetes on short- and long-term outcomes after left ventricular assist device implantation. J Heart Lung Transplant. 2005 Dec;24(12):2048-53. PMID: 16364848

Abstract
BACKGROUND:
Diabetes mellitus (DM) is a frequent co-morbidity in patients with congestive heart failure (CHF). Implantation of LVADs is an acceptable option for diabetic patients with end-stage heart failure… Show more

Topkara VK, Dang NC, Martens TP, Cheema FH, Liu JF, Liang LM, Cheema AF, Barili F, Oz MC, Naka Y. Effect of diabetes on short- and long-term outcomes after left ventricular assist device implantation. J Heart Lung Transplant. 2005 Dec;24(12):2048-53. PMID: 16364848

Abstract
BACKGROUND:
Diabetes mellitus (DM) is a frequent co-morbidity in patients with congestive heart failure (CHF). Implantation of LVADs is an acceptable option for diabetic patients with end-stage heart failure, yet no previous study has specifically examined the clinical outcomes of this patient population.
METHODS:
A retrospective analysis was performed on all patients who underwent LVAD insertion at a single institution from June 17, 1996 to April 14, 2004. Patients were divided into 2 groups: diabetics (DM) and non-diabetics (NDM). The groups were compared with regard to demographics, etiology of heart failure, body mass index (BMI), intensive care unit (ICU) stay, early mortality (< or =30 days), bridge-to-transplantation rate and post-LVAD and post-transplant survival.
RESULTS:
Two hundred one patients were identified. Of these, 49 (24.4%) had DM. Compared with the NDM group, DM patients had a higher mean body mass index (30.1 +/- 6.0 vs 26.1 +/- 4.8, p < 0.001) and a higher proportion of hypertension (57.4% vs 19.7%, p < 0.001). Although post-LVAD survival was similar, post-transplant survival in DM patients was significantly lower compared with NDM patients, with 1-, 3-, 5- and 7-year actuarial survival rates of 86.9%, 71.0%, 56.5% and 56.5% vs 90.5%, 88.4%, 83.0% and 80.7% (p = 0.020), respectively.
CONCLUSIONS:
Carefully selected diabetic patients can be successfully bridged to transplantation using LVADs with comparable outcomes to non-diabetic patients. Reasons for diminished post-transplant survival in this cohort are unclear and necessitate the conductance of multi-institutional studies to evaluate outcomes. Show less

Kaplan S, Bisleri G, Morgan JA, Cheema FH, Oz MC. Resveratrol, a natural red wine polyphenol, reduces ischemia-reperfusion-induced spinal cord injury. Ann Thorac Surg. 2005 Dec;80(6):2242-9. PMID: 16305881

Abstract
BACKGROUND:
Severe neurologic injury still represents one of the most devastating complications after surgical repair of thoracoabdominal aneurysms. We therefore aimed to investigate the protective effect of resveratrol, a natural polyphenol antioxidant present in grapes… Show more

Kaplan S, Bisleri G, Morgan JA, Cheema FH, Oz MC. Resveratrol, a natural red wine polyphenol, reduces ischemia-reperfusion-induced spinal cord injury. Ann Thorac Surg. 2005 Dec;80(6):2242-9. PMID: 16305881

Abstract
BACKGROUND:
Severe neurologic injury still represents one of the most devastating complications after surgical repair of thoracoabdominal aneurysms. We therefore aimed to investigate the protective effect of resveratrol, a natural polyphenol antioxidant present in grapes and wine, in an experimental model of spinal cord ischemia-reperfusion injury.
METHODS:
Sixteen rabbits were assigned either to group A (n = 8; receiving resveratrol, treated group) or group B (n = 8; control group, nontreated group) and underwent a 30-minutes period of spinal cord ischemia by clamping the abdominal aorta between the left renal artery and the aortic bifurcation. Fifteen minutes before clamping, rabbits received either intravenous resveratrol (100 microg/kg; group A) or normal saline (group B). Functional assessment with Tarlov score at 8, 16, and 24 hours postoperatively, histopathologic assessment of the spinal cord, measurements of malondialdehyde levels, and myeloperoxidase activity in the spinal cord were performed.
RESULTS:
Neurologic impairment (Tavlov score for group A = 4.38 +/- 1.19 and for group B = 0.38 +/- 0.74, p < 0.001), malondialdehyde levels (47.71 +/- 7.81 nmol/g versus 86.56 +/- 11.39 nmol/g, p < 0.001), and myeloperoxidase activity (2.13 +/- 0.72 nm/min versus 3.75 +/- 0.78 nm/min, p = 0.002) were significantly lower in the resveratrol-treated animals. Additionally, pathologically assessed outcomes were better in the resveratrol-treated group. The total number of motor neurons in the gray matter was significantly lower in the nontreated group than in the resveratrol-treated group (14.26 +/- 2.94 versus 29.12 +/- 3.64, p = 0.003).
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/16305881 Show less

Topkara VK, Dang NC, John R, Cheema FH, Barbato R, Cavallo M, Liu JF, Liang LM, Liberman EA, Argenziano M, Oz MC, Naka Y. A decade experience of cardiac retransplantation in adult recipients. J Heart Lung Transplant. 2005 Nov;24(11):1745-50. Epub 2005 Jun 4. PMID: 16297775

Abstract
BACKGROUND:
Cardiac retransplantation is considered to be the best therapeutic option for a failing cardiac allograft. However, poor outcomes with retransplantation have previously been reported, a… Show more

Topkara VK, Dang NC, John R, Cheema FH, Barbato R, Cavallo M, Liu JF, Liang LM, Liberman EA, Argenziano M, Oz MC, Naka Y. A decade experience of cardiac retransplantation in adult recipients. J Heart Lung Transplant. 2005 Nov;24(11):1745-50. Epub 2005 Jun 4. PMID: 16297775

Abstract
BACKGROUND:
Cardiac retransplantation is considered to be the best therapeutic option for a failing cardiac allograft. However, poor outcomes with retransplantation have previously been reported, a factor that raises important ethical, logistic and financial issues given the limited organ donor supply.
METHODS:
Seven hundred sixty-six adult patients underwent cardiac transplantation for end-stage heart failure at our institution from 1992 to 2002. Of these, 41 (5.4%) were retransplants. Variables examined included recipient and donor demographics, indications for retransplant, comorbidities, cytomegalovirus (CMV) serology status, left ventricular assist device use before transplant, donor ischemic time, rate of early mortality (within 30 days), and post-transplantation survival rate.
RESULTS:
Indications for cardiac retransplant were transplant-related coronary artery disease in 37, acute rejection in 3, and other causes in 1. The mean interval between transplantation and retransplantation was 5.9 +/- 3.4 years. Baseline characteristics such as recipient age, gender, CMV serology status, and donor age were similar in the primary transplant and retransplant groups. Early mortality after transplantation was comparable between the 2 groups, but post-transplant survival was significantly lower in retransplant patients compared with primary transplants with 1-, 3-, 5-, and 7-year actuarial survival rates of 72.2%, 66.3%, 47.5%, and 40.7% vs. 85.1%, 79.2%, 72.9%, and 66.8%, respectively (p < 0.001).
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/16297775 Show less

Kaplan S, Morgan JA, Bisleri G, Cheema FH, Akman HO, Topkara VK, Oz MC. Effects of resveratrol in storage solution on adhesion molecule expression and nitric oxide synthesis in vein grafts. Ann Thorac Surg. 2005 Nov;80(5):1773-8. PMID: 16242454

Abstract
BACKGROUND:
Endothelial injury in human saphenous vein grafts may occur during harvesting and storage, which may have an adverse effect on coronary artery bypass grafting outcome. In this study, we sought to determine whether… Show more

Kaplan S, Morgan JA, Bisleri G, Cheema FH, Akman HO, Topkara VK, Oz MC. Effects of resveratrol in storage solution on adhesion molecule expression and nitric oxide synthesis in vein grafts. Ann Thorac Surg. 2005 Nov;80(5):1773-8. PMID: 16242454

Abstract
BACKGROUND:
Endothelial injury in human saphenous vein grafts may occur during harvesting and storage, which may have an adverse effect on coronary artery bypass grafting outcome. In this study, we sought to determine whether resveratrol, a natural antioxidant enriched in grape, can limit endothelial activation and reduce endothelial injury in human saphenous vein grafts.
METHODS:
Human saphenous vein grafts, obtained from 8 patients and divided into two equal groups of control and study specimens, were stored in either heparinized blood (group A) or heparinized blood containing 50 microg/mL resveratrol (group B) for 1 hour at room temperature. Specimens were analyzed by Western blotting to quantify intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and inducible nitric oxide synthase-2 expression, as well as tissue cyclic guanylate monophosphate levels. Myeloperoxidase activity, a marker of neutrophil sequestration in human saphenous vein grafts, was also measured in each group.
RESULTS:
Intercellular adhesion molecule-1 expression (1,674 +/- 332 versus 559 +/- 282; p = 0.003), vascular cell adhesion molecule-1 expression (753 +/- 183 versus 472 +/- 151; p = 0.025), and myeloperoxidase activity (7.00 +/- 1.05 versus 1.33 +/- 0.45 nm/min; p = 0.004) were significantly lower in group B. In contrast, inducible nitric oxide synthase-2 expression (548 +/- 237 versus 2,234 +/- 726; p = 0.004) and tissue cyclic guanylate monophosphate levels (2.02 +/- 0.53 versus 5.61 +/- 0.89 pmol/mL; p = 0.001) were significantly higher in group B.
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/16242454 Show less

Martens TP, Morgan JA, Hefti MM, Brunacci DA, Cheema FH, Kesava SK, Xydas S, Dang NC, Vigilance DW, Kohmoto T, Gorenstein LA, Smith CR Jr, Argenziano M. Adhesiolysis is facilitated by robotic technology in reoperative cardiac surgery. Ann Thorac Surg. 2005 Sep;80(3):1103-5. PMID: 16122499

Abstract
Over a 2-year period, 5 patients who required reoperative chest surgery underwent robotic adhesiolysis with the da Vinci (Intuitive, Sunnyvale, CA) system. Resternotomy was performed under… Show more

Martens TP, Morgan JA, Hefti MM, Brunacci DA, Cheema FH, Kesava SK, Xydas S, Dang NC, Vigilance DW, Kohmoto T, Gorenstein LA, Smith CR Jr, Argenziano M. Adhesiolysis is facilitated by robotic technology in reoperative cardiac surgery. Ann Thorac Surg. 2005 Sep;80(3):1103-5. PMID: 16122499

Abstract
Over a 2-year period, 5 patients who required reoperative chest surgery underwent robotic adhesiolysis with the da Vinci (Intuitive, Sunnyvale, CA) system. Resternotomy was performed under direct visualization for coronary revascularization (n = 2) or valve replacement (n = 1). A fourth patient required coronary revascularization after a previous axilloaxillary bypass. The final case involved the preparation of a substernal pathway for a gastric pull-up. In all cases adhesions were taken down without injury to the underlying structures. All grafts were preserved, and all patients recovered uneventfully. Robotic adhesiolysis is a versatile technique that allows careful lysis of adhesions and minimizes the risk of major complication during reoperative chest surgery. Show less

Topkara VK, Dang NC, Martens TP, Cheema FH, Liu JF, Argenziano M, Naka Y. Bridging to transplantation with left ventricular assist devices: outcomes in patients aged 60 years and older. J Thorac Cardiovasc Surg. 2005 Sep;130(3):881-2. PMID: 16153945

Topkara VK, Cheema FH, Kesavaramanujam S, Mercando ML, Cheema AF, Namerow PB, Argenziano M, Naka Y, Oz MC, Esrig BC. Coronary artery bypass grafting in patients with low ejection fraction. Circulation. 2005 Aug 30;112(9 Suppl):I344-50. PMID: 16159844

Abstract
BACKGROUND:
Patients with low ejection fraction (EF) are at a higher risk for postoperative complications and mortality. Our objective was to assess the effect of low EF on clinical outcomes after coronary artery bypass… Show more

Topkara VK, Cheema FH, Kesavaramanujam S, Mercando ML, Cheema AF, Namerow PB, Argenziano M, Naka Y, Oz MC, Esrig BC. Coronary artery bypass grafting in patients with low ejection fraction. Circulation. 2005 Aug 30;112(9 Suppl):I344-50. PMID: 16159844

Abstract
BACKGROUND:
Patients with low ejection fraction (EF) are at a higher risk for postoperative complications and mortality. Our objective was to assess the effect of low EF on clinical outcomes after coronary artery bypass grafting (CABG).
METHODS AND RESULTS:
We analyzed 55,515 patients from New York State database who underwent CABG between 1997 and 1999. Patients were stratified into 1 of the 4 EF groups: Group I (EF< or =20%), Group II (EF 21% to 30%), Group III (EF 31% to 40%), and Group IV (EF>40%). History of previous myocardial infarction, renal failure, and congestive heart failure were higher in patients with low EF (all P<0.001). Group I experienced a higher incidence of postoperative respiratory failure (10.1% versus 2.9%), renal failure (2.5% versus 0.6%), and sepsis (2.5% versus 0.6%) compared with Group IV. In-hospital mortality was significantly higher in Group I (6.5% versus 1.4%; P<0.001). Multivariate analysis showed hepatic failure [odds ratio (OR), 11.2], renal failure (OR, 4.1), previous myocardial infarction (OR, 3.4), reoperation (OR, 3.4), emergent procedures (OR, 3.2), female gender (OR, 1.7), congestive heart failure (OR, 1.6), and age (OR, 1.04) as independent predictors of in-hospital mortality in the low EF group. The discharges to home rate were significantly lower in Group I versus Group IV (73.1% and 87.7%, respectively; P<0.001).
CONCLUSIONS:
Patients with low EF are sicker at baseline and have >4 times higher mortality than patients with high EF. However, outcomes are improving over time and are superior to historical data. Therefore, CABG remains a viable option in selected patients with low EF. Show less

Dang NC, Cheema FH, Oz MC. Advances in heart failure surgery. Future Cardiol. 2005 Mar;1(2):257-67. doi: 10.1517/14796678.1.2.257. PMID: 19804170

Abstract
Heart failure is a major public health problem in the USA and in most Western countries. Nearly 5 million patients in the USA have heart failure with approximately 500,000 patients being diagnosed for the first time each year. Medical therapy is the first-line treatment, and surgery is considered when medical therapy fails or a… Show more

Dang NC, Cheema FH, Oz MC. Advances in heart failure surgery. Future Cardiol. 2005 Mar;1(2):257-67. doi: 10.1517/14796678.1.2.257. PMID: 19804170

Abstract
Heart failure is a major public health problem in the USA and in most Western countries. Nearly 5 million patients in the USA have heart failure with approximately 500,000 patients being diagnosed for the first time each year. Medical therapy is the first-line treatment, and surgery is considered when medical therapy fails or a clear mechanical cause of heart failure is identified and deemed correctable. Current surgical options include coronary revascularization, surgical correction of mitral regurgitation, left ventricular reconstruction, transmyocardial laser revascularization, ventricular assist devices, passive ventricular restraint devices, and cardiac transplantation. While a full discussion of cardiac transplantation is beyond the scope of this article, the other commonly performed procedures will be reviewed. Show less

Mori K, Lee HT, Rapoport D, Drexler IR, Foster K, Yang J, Schmidt-Ott KM, Chen X, Li JY, Weiss S, Mishra J, Cheema FH, Markowitz G, Suganami T, Sawai K, Mukoyama M, Kunis C, D'Agati V, Devarajan P, Barasch J. Endocytic delivery of lipocalin-siderophore-iron complex rescues the kidney from ischemia-reperfusion injury. J Clin Invest. 2005 Mar;115(3):610-21. PMID: 15711640

Abstract
Neutrophil gelatinase-associated lipocalin (Ngal), also known as siderocalin, forms a complex with… Show more

Mori K, Lee HT, Rapoport D, Drexler IR, Foster K, Yang J, Schmidt-Ott KM, Chen X, Li JY, Weiss S, Mishra J, Cheema FH, Markowitz G, Suganami T, Sawai K, Mukoyama M, Kunis C, D'Agati V, Devarajan P, Barasch J. Endocytic delivery of lipocalin-siderophore-iron complex rescues the kidney from ischemia-reperfusion injury. J Clin Invest. 2005 Mar;115(3):610-21. PMID: 15711640

Abstract
Neutrophil gelatinase-associated lipocalin (Ngal), also known as siderocalin, forms a complex with iron-binding siderophores (Ngal:siderophore:Fe). This complex converts renal progenitors into epithelial tubules. In this study, we tested the hypothesis that Ngal:siderophore:Fe protects adult kidney epithelial cells or accelerates their recovery from damage. Using a mouse model of severe renal failure, ischemia-reperfusion injury, we show that a single dose of Ngal (10 microg), introduced during the initial phase of the disease, dramatically protects the kidney and mitigates azotemia. Ngal activity depends on delivery of the protein and its siderophore to the proximal tubule. Iron must also be delivered, since blockade of the siderophore with gallium inhibits the rescue from ischemia. The Ngal:siderophore:Fe complex upregulates heme oxygenase-1, a protective enzyme, preserves proximal tubule N-cadherin, and inhibits cell death. Because mouse urine contains an Ngal-dependent siderophore-like activity, endogenous Ngal might also play a protective role. Indeed, Ngal is highly accumulated in the human kidney cortical tubules and in the blood and urine after nephrotoxic and ischemic injury. We reveal what we believe to be a novel pathway of iron traffic that is activated in human and mouse renal diseases, and it provides a unique method for their treatment. Show less

Pinney SP, Cheema FH, Hammond K, Chen JM, Edwards NM, Mancini D. Acceptable recipient outcomes with the use of hearts from donors with hepatitis-B core antibodies. J Heart Lung Transplant. 2005 Jan;24(1):34-7. PMID: 15653376

Abstract
BACKGROUND:
The shortage of available donors limits cardiac transplantation. Use of hearts from patients with hepatitis-B core antibodies could expand the donor pool but are usually avoided because of concern about virus transmission. We conducted a… Show more

Pinney SP, Cheema FH, Hammond K, Chen JM, Edwards NM, Mancini D. Acceptable recipient outcomes with the use of hearts from donors with hepatitis-B core antibodies. J Heart Lung Transplant. 2005 Jan;24(1):34-7. PMID: 15653376

Abstract
BACKGROUND:
The shortage of available donors limits cardiac transplantation. Use of hearts from patients with hepatitis-B core antibodies could expand the donor pool but are usually avoided because of concern about virus transmission. We conducted a retrospective review to determine the safety of transplanting hearts from donors with hepatitis-B core antibodies.
METHODS:
We reviewed donor and recipient charts for patients who underwent transplantation at our center between January 1, 1997, and December 1, 2002.
RESULTS:
A total of 541 heart transplantations were performed in this time period. Thirty-three patients (aged 47.5 +/- 18.8 years) received hearts from core-antibody-positive donors (aged 37.7 +/- 10.8 years). Of these, 5 patients received prophylactic antibiotic treatment with lamivudine after transplantation. Only 1 patient (baseline surface-antigen-negative and without prophylaxis) experienced donor-transmitted hepatitis B infection 10 months after transplantation that was treated with lamivudine. Two patients (baseline surface-antibody-negative) had hepatitis B seroconversion, becoming surface-antibody positive without evidence of infection. None of the 5 patients who received prophylaxis with lamivudine had donor-transmitted hepatitis, and only 1 lamivudine-treated patient had surface antibodies. Post-transplant survival in this small cohort was similar to that for all patients who underwent transplantation at our center during this time period.
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/15653376 Show less

Oliver JA, Maarouf O, Cheema FH, Martens TP, Al-Awqati Q. The renal papilla is a niche for adult kidney stem cells. J Clin Invest. 2004 Sep;114(6):795-804. PMID: 15372103

Abstract
Many adult organs contain stem cells, which are pluripotent and are involved in organ maintenance and repair after injury. In situ, these cells often have a low cycling rate and locate in specialized regions (niches). To detect such cells in the kidney, we administered a pulse of the nucleotide… Show more

Oliver JA, Maarouf O, Cheema FH, Martens TP, Al-Awqati Q. The renal papilla is a niche for adult kidney stem cells. J Clin Invest. 2004 Sep;114(6):795-804. PMID: 15372103

Abstract
Many adult organs contain stem cells, which are pluripotent and are involved in organ maintenance and repair after injury. In situ, these cells often have a low cycling rate and locate in specialized regions (niches). To detect such cells in the kidney, we administered a pulse of the nucleotide bromodeoxyuridine (BrdU) to rat and mouse pups and, after a long (more than 2-month) chase, examined whether the kidney contained a population of low-cycling cells. We found that in the adult kidney, BrdU-retaining cells were very sparse except in the renal papilla, where they were numerous. During the repair phase of transient renal ischemia, these cells entered the cell cycle and the BrdU signal quickly disappeared from the papilla, despite the absence of apoptosis in this part of the kidney. In vitro isolation of renal papillary cells showed them to have a plastic phenotype that could be modulated by oxygen tension and that when injected into the renal cortex, they incorporated into the renal parenchyma. In addition, like other stem cells, papillary cells spontaneously formed spheres. Single-cell clones of these cells coexpressed mesenchymal and epithelial proteins and gave rise to myofibroblasts, cells expressing neuronal markers, and cells of uncharacterized phenotype. These data indicate that the renal papilla is a niche for adult kidney stem cells. Show less

Kherani AR, Cheema FH, Casher J, Fal JM, Mutrie CJ, Chen JM, Morgan JA, Vigilance DW, Garrido MJ, Smith CR, Oz MC. Edge-to-edge mitral valve repair: the Columbia Presbyterian experience. Ann Thorac Surg. 2004 Jul;78(1):73-6. PMID: 15223406

Abstract
BACKGROUND:
The edge-to-edge mitral valve repair, first described by Alfieri in 1995 treats mitral regurgitation when standard reparative techniques are difficult, unlikely to succeed, or have failed. This study examines one… Show more

Kherani AR, Cheema FH, Casher J, Fal JM, Mutrie CJ, Chen JM, Morgan JA, Vigilance DW, Garrido MJ, Smith CR, Oz MC. Edge-to-edge mitral valve repair: the Columbia Presbyterian experience. Ann Thorac Surg. 2004 Jul;78(1):73-6. PMID: 15223406

Abstract
BACKGROUND:
The edge-to-edge mitral valve repair, first described by Alfieri in 1995 treats mitral regurgitation when standard reparative techniques are difficult, unlikely to succeed, or have failed. This study examines one institution's medium-term experience with this procedure.
METHODS:
This study involved patients undergoing edge-to-edge mitral valve repair at a single institution from 1997 to 2003. Preoperative and postoperative echocardiograms were compared. Postoperative morbidity was examined including need for reoperation and long-term medical management. Thirty-day survival and long-term actuarial survival were also determined.
RESULTS:
Seventy-one patients comprised this study. Mitral regurgitation on echocardiogram went from 3.43 +/- 0.86 to 0.39 +/- 0.61 (p < 0.001) following repair. Thirty-day mortality was 3 of 71 (4.2%) patients. Actuarial survivals at 24 and 60 months were 84.5% and 58.3%, respectively; adjusted excluding noncardiac death they were 89.5% and 82.3%, respectively. Forty (56.3%) patients had concomitant ring placement and experienced similar survival to those repaired with the bow-tie stitch alone. Home telephone follow-up was conducted, and current medical therapy was determined on 51 patients; 59% were on a beta-blocker, 31% were on an angiotensin-converting enzyme (ACE) inhibitor, 27% were on a diuretic, and 22% were on digoxin. All were New York Heart Association (NYHA) class I or II. Three patients (4.2%) underwent mitral valve reoperation after a mean of 299 +/- 429 days. In no case did the bow-tie suture rupture.
CONCLUSIONS:
Refer to PubMed at http://www.ncbi.nlm.nih.gov/pubmed/15223406 Show less

Kherani AR, Lazar RM, Xydas S, Mazzeo PA, Fal JM, Mongero L, Vigilance DW, Morgan JA, Cheema FH, Burton EH, Moss GW, Oz MC. Magnetic resonance imaging to detect acute cerebral events in on-pump and hybrid-pump patients. Heart Surg Forum. 2004 Jun 1;7(4):E265-8. PMID: 15454375

Abstract

BACKGROUND:
Conventional cardiopulmonary bypass results in cerebral ischemic sequelae that may be reduced with hybrid pump technologies, such as the CardioVention system (CardioVention, Santa… Show more

Kherani AR, Lazar RM, Xydas S, Mazzeo PA, Fal JM, Mongero L, Vigilance DW, Morgan JA, Cheema FH, Burton EH, Moss GW, Oz MC. Magnetic resonance imaging to detect acute cerebral events in on-pump and hybrid-pump patients. Heart Surg Forum. 2004 Jun 1;7(4):E265-8. PMID: 15454375

Abstract

BACKGROUND:
Conventional cardiopulmonary bypass results in cerebral ischemic sequelae that may be reduced with hybrid pump technologies, such as the CardioVention system (CardioVention, Santa Clara, CA, USA). CardioVention differs from conventional bypass in that it has a novel air elimination module and reduced membrane surface area and priming volume. This preliminary study tested whether this pump confers neurological safety advantages over conventional bypass.
METHODS:
Ten patients were studied, with 6 assigned to on-pump coronary artery bypass grafting and 4 to the CardioVention system. No patients had any stroke history. Within 72 hours postsurgery, each underwent diffusion-weighted magnetic resonance imaging, a sensitive test for cerebral ischemic events.
RESULTS:
Two on-pump patients (33%) had postoperative findings on imaging, but none of the CardioVention patients demonstrated comparable changes ( P =.47). No patients had symptoms of acute stroke.
CONCLUSION:
Postoperative magnetic resonance imaging showed a trend toward a greater rate of ischemic events in patients undergoing traditional on-pump surgery. These preliminary findings suggest that hybrid pump technologies, such as the CardioVention system, may attenuate the risk of short-term neurological complications. Future studies are indicated to confirm these subclinical ischemic changes and to correlate them with long-term neurocognitive changes. Show less

Morgan JA, Peacock JC, Kohmoto T, Garrido MJ, Schanzer BM, Kherani AR, Vigilance DW, Cheema FH, Kaplan S, Smith CR, Oz MC, Argenziano M. Robotic techniques improve quality of life in patients undergoing atrial septal defect repair. Ann Thorac Surg. 2004 Apr;77(4):1328-33. PMID: 15063261

Abstract
BACKGROUND:
Minimally invasive cardiac surgery has emerged as an alternative to conventional, open surgery. Although most studies of robotically assisted cardiac surgery have reported… Show more

Morgan JA, Peacock JC, Kohmoto T, Garrido MJ, Schanzer BM, Kherani AR, Vigilance DW, Cheema FH, Kaplan S, Smith CR, Oz MC, Argenziano M. Robotic techniques improve quality of life in patients undergoing atrial septal defect repair. Ann Thorac Surg. 2004 Apr;77(4):1328-33. PMID: 15063261

Abstract
BACKGROUND:
Minimally invasive cardiac surgery has emerged as an alternative to conventional, open surgery. Although most studies of robotically assisted cardiac surgery have reported morbidity and mortality, few have addressed outcome measures, such as pain and quality of life, which was the aim of this study.
METHODS:
Eleven patients with atrial septal defects (ASD), and five patients with patent foramen ovale, underwent repair using the Da Vinci system (Intuitive Surgical, Mountain View, CA). The Medical Outcomes Study Short Form Survey (SF-36), along with two additional questions, were administered to these patients on postoperative day 30, along with a similar number of patients who underwent ASD repair by mini-thoracotomy or sternotomy. Quality of life endpoints included bodily pain, vitality, mental health, general health, physical function, and social function.
RESULTS:
Robotic patients demonstrated significantly higher scores in 6 of the eight variables (p < 0.05). There was no significant difference in intensive care unit or overall hospital stay among the groups (p = NS). Robotic patients returned to work after 40.2 +/- 30.2 days, mini-thoracotomy patients after 45.6 +/- 27.9 days, and sternotomy patients after 51.7 +/- 40.2 days (p = 0.767). There were no significant differences in SF-36 scores between patients who underwent mini-thoracotomy and sternotomy approaches.
CONCLUSIONS:
Closure of an ASD can be performed safely and effectively via an endoscopic approach. Robotic technology minimized the degree of invasiveness, hastened postoperative recovery, and improved quality of life, although length of hospital stay was unchanged.
Show less

Kherani AR, Cheema FH, Oz MC, Fal JM, Morgan JA, Topkara VK, Wilson DA, Vigilance DW, Garrido MJ, Naka Y. Implantation of a left ventricular assist device and the hub-and-spoke system in treating acute cardiogenic shock: who survives? J Thorac Cardiovasc Surg. 2003 Nov;126(5):1634-5. PMID: 14666044

Morgan JA, John R, Weinberg AD, Kherani AR, Colletti NJ, Vigilance DW, Cheema FH, Bisleri G, Cosola T, Mancini DM, Oz MC, Edwards NM. Prolonged donor ischemic time does not adversely affect long-term survival in adult patients undergoing cardiac transplantation. J Thorac Cardiovasc Surg. 2003 Nov;126(5):1624-33. PMID: 14666043

Abstract
OBJECTIVE:
With liberalization of donor eligibility criteria, organs are being harvested from remote locations, increasing donor ischemic times… Show more

Morgan JA, John R, Weinberg AD, Kherani AR, Colletti NJ, Vigilance DW, Cheema FH, Bisleri G, Cosola T, Mancini DM, Oz MC, Edwards NM. Prolonged donor ischemic time does not adversely affect long-term survival in adult patients undergoing cardiac transplantation. J Thorac Cardiovasc Surg. 2003 Nov;126(5):1624-33. PMID: 14666043

Abstract
OBJECTIVE:
With liberalization of donor eligibility criteria, organs are being harvested from remote locations, increasing donor ischemic times. Although several studies have evaluated the effects of prolonged donor ischemic times on short-term survival and graft function, few have addressed concerns regarding long-term survival.
METHODS:
Over the last 11 years, 819 consecutive adults underwent cardiac transplantation at Columbia Presbyterian Medical Center. Recipients were separated into the following 4 groups based on donor ischemic time: <150 minutes, 150 to 200 minutes, 200 to 250 minutes, and >250 minutes. Statistical analysis included Kaplan-Meier survival & Cox proportional hazard models to identify predictors of long-term survival.
RESULTS:
Donor ischemic time was 120.1 +/- 21.1 minutes for group 1 (n = 321), 174.1 +/- 14.7 minutes for group 2 (n = 264), 221.7 +/- 14.6 minutes for group 3 (n = 154), and 295.5 +/- 37.1 minutes for group 4 (n = 80) (P <.001). There were no significant differences in recipient age, donor age, etiology of heart failure, United Network for Organ Sharing status, or history of previous cardiac surgery among the groups (P = NS). Prolonged donor ischemic time did not adversely affect long-term survival, with actuarial survival at 1, 5, and 10 years of 86.9%, 75.2%, and 56.4% for group 1; 86.2%, 76.9%, and 50.9% for group 2; 86.4%, 71.0%, and 43.7% for group 3; and 86.7%, 70.1%, and 50.9% for group 4 (P =.867). There was no significant difference in freedom from transplant coronary artery disease among the 4 groups (P =.474).
CONCLUSIONS:
Refer to PubMed at: http://www.ncbi.nlm.nih.gov/pubmed/14666043 Show less

Morgan JA, Park Y, Kherani AR, Vigilance DW, Cheema FH, Oz MC, Naka Y. Does bridging to transplantation with a left ventricular assist device adversely affect posttransplantation survival? A comparative analysis of mechanical versus inotropic support. J Thorac Cardiovasc Surg. 2003 Oct;126(4):1188-90. PMID: 14566269

Morgan JA, Morales DL, John R, Ginsburg ME, Kherani AR, Vigilance DW, Cheema FH, Smith CR Jr, Oz MC, Argenziano M. Endoscopic, robotically assisted implantation of phrenic pacemakers. J Thorac Cardiovasc Surg. 2003 Aug;126(2):582-3. PMID: 12928662

Morgan JA, Kherani AR, Vigilance DW, Cheema FH, Colletti NJ, Sahar DI, Jan KM, Diuguid DL, Nowygrod R, Oz MC, Argenziano M. Off-pump right atrial thrombectomy for heparin-induced thrombocytopenia with thrombosis. Ann Thorac Surg. 2003 Aug;76(2):615-7. PMID: 12902120

ABSTRACT
This report describes a 72-year-old woman with atrial fibrillation who presented with lower extremity ischemia secondary to thromboembolism. After lower extremity thrombectomy, the patient developed… Show more

Morgan JA, Kherani AR, Vigilance DW, Cheema FH, Colletti NJ, Sahar DI, Jan KM, Diuguid DL, Nowygrod R, Oz MC, Argenziano M. Off-pump right atrial thrombectomy for heparin-induced thrombocytopenia with thrombosis. Ann Thorac Surg. 2003 Aug;76(2):615-7. PMID: 12902120

ABSTRACT
This report describes a 72-year-old woman with atrial fibrillation who presented with lower extremity ischemia secondary to thromboembolism. After lower extremity thrombectomy, the patient developed heparin-induced thrombocytopenia with thrombosis (HITT). Her postoperative course was complicated by recurrent supraventricular and ventricular tachycardia, secondary to a mobile thrombus in the right atrium extending into the right ventricle. Because administration of heparin was contraindicated, the patient underwent off-pump right atrial thrombectomy during a brief period of inflow occlusion. Postoperatively, she was placed on lepirudin. Her platelet count normalized without any further thrombotic episodes, and she was discharged on warfarin. Show less

Kherani AR, Garrido MJ, Cheema FH, Naka Y, Oz MC. Nontransplant surgical options for congestive heart failure. Congest Heart Fail. 2003 Jan-Feb;9(1):17-24. PMID: 12556673

ABSTRACT
A wide array of surgical options are currently available for the treatment of congestive heart failure ranging from traditional coronary artery bypass grafting to total artificial heart implantation. The indications for each procedure depend on the severity of disease and the individual patients desires… Show more

Kherani AR, Garrido MJ, Cheema FH, Naka Y, Oz MC. Nontransplant surgical options for congestive heart failure. Congest Heart Fail. 2003 Jan-Feb;9(1):17-24. PMID: 12556673

ABSTRACT
A wide array of surgical options are currently available for the treatment of congestive heart failure ranging from traditional coronary artery bypass grafting to total artificial heart implantation. The indications for each procedure depend on the severity of disease and the individual patients desires. Some surgical options are indicated for patients with moderate disease and prevent worsening heart failure, whereas other procedures are limited to patients who will only survive with high-risk surgery. Ongoing technologic advances are increasing the number of patients that benefit from the reparative surgical treatment of congestive heart failure.

Copyright 2003 CHF, Inc. Show less

Ahmed D, Cheema FH, Sami SA, Sarwari AR. Post-coronary artery bypass surgery pericardial abscess: Salmonella paratyphi B. J Infect. 2001 Jul;43(1):17-8. PMID: 11597151

Abstract:
Endemic enteric fever is one of the major health problems in South Asia where focal pyogenic infections with salmonella are being increasingly reported. A pericardial abscess following coronary artery bypass surgery with Salmonella paratyphi B was successfully treated, the first reported case so… Show more

Ahmed D, Cheema FH, Sami SA, Sarwari AR. Post-coronary artery bypass surgery pericardial abscess: Salmonella paratyphi B. J Infect. 2001 Jul;43(1):17-8. PMID: 11597151

Abstract:
Endemic enteric fever is one of the major health problems in South Asia where focal pyogenic infections with salmonella are being increasingly reported. A pericardial abscess following coronary artery bypass surgery with Salmonella paratyphi B was successfully treated, the first reported case so far.

Copyright 2001 The British Infection Society. Show less

Rabbani F, Cheema FH, Talati N, Siddiqui S, Syed S, Bashir S, Zuberi LZ, Shamim A, Mumtaz Q. Behind the counter: pharmacies and dispensing patterns of pharmacy attendants in Karachi. J Pak Med Assoc. 2001 Apr;51(4):149-53. PMID: 11759497

ABSTRACT
Background:
There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in developing countries.
Objective:
This study obtained background information on pharmacies, assessed the… Show more

Rabbani F, Cheema FH, Talati N, Siddiqui S, Syed S, Bashir S, Zuberi LZ, Shamim A, Mumtaz Q. Behind the counter: pharmacies and dispensing patterns of pharmacy attendants in Karachi. J Pak Med Assoc. 2001 Apr;51(4):149-53. PMID: 11759497

ABSTRACT
Background:
There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in developing countries.
Objective:
This study obtained background information on pharmacies, assessed the level of training, knowledge and dispensing patterns of pharmacy attendants in Karachi.
Methodology:
This is a descriptive cross sectional study with convenient sampling. A structured questionnaire was used to interview pharmacy attendants.
Results:
Of the 219 pharmacies surveyed, 62% reported more than 50 customers daily and 20% also sold items of general provision. Mean operating hours were 13. Only 24 (11%) had a visible license. On an average 3 attendants were employed per pharmacy. We interviewed one in each. Amongst the 219 interviewed, 77 (35%) were intermediate qualified and only 26 (12%) pharmacologically trained. Correct frequency of ORS administration was not known by 167 (76%) and 21% incorrectly suggested an anti-diarrhoeal preparation for viral diarrhoea in children. The knowledge of those with pharmacological training was significantly better. For respiratory tract infection in children approximately 60% did not know the correct dose of Paracetamol and Amoxicillin. Only 13 (6%) knew that Propanalol was contraindicated in hypertensive asthamatics. For Cotrimoxazole, metronidazole and lomotil only 40%, 21% and 15% respectively, were aware that these could not be dispensed without prescription.
Conclusion:
In the absence of trained pharmacists existing pharmacy attendants should be trained to improve drug-dispensing patterns. Show less

Cheema FH, Yusuf RZ. "A shadow apart": a symposium on biomedical imaging. J Pak Med Assoc. 1998 Dec;48(12):383-4. PMID: 10531777

Rabkin DG, Cabreriza SE, Cheema FH, Hill AA, Curtis LJ, Sciacca RR, Mosca RS, Spotnitz HM. Cariporide is cardioprotective after iatrogenic ventricular fibrillation in the intact swine heart. Ann Thorac Surg. 2003 Oct;76(4):1264-9; discussion 1269. PMID: 14530023

Abstract

BACKGROUND:
We sought to introduce sodium-hydrogen exchange inhibition as prophylaxis against the development of ventricular dysfunction in the setting of implantable cardioverter defibrillator insertion in… Show more

Rabkin DG, Cabreriza SE, Cheema FH, Hill AA, Curtis LJ, Sciacca RR, Mosca RS, Spotnitz HM. Cariporide is cardioprotective after iatrogenic ventricular fibrillation in the intact swine heart. Ann Thorac Surg. 2003 Oct;76(4):1264-9; discussion 1269. PMID: 14530023

Abstract

BACKGROUND:
We sought to introduce sodium-hydrogen exchange inhibition as prophylaxis against the development of ventricular dysfunction in the setting of implantable cardioverter defibrillator insertion in high-risk patients. Cariporide, shown to be safe in humans, was used to reproduce previous results in our laboratory that demonstrated that sodium-hydrogen exchange inhibition preserves left ventricular (LV) function after ventricular fibrillation (VF) and reperfusion.
METHODS:
Twelve pigs (weight, 35 to 55 kg) were divided into two groups of six. Baseline ventricular function studies were based on echocardiography, conductance, aortic flow, and LV pressure. Animals were given vehicle (control) or cariporide (3 mg/kg intravenously). Ten minutes later, hearts underwent 80 seconds of VF. After reperfusion for 40 minutes, function studies were repeated.
RESULTS:
Refer to PubMed: http://www.ncbi.nlm.nih.gov/pubmed/14530023
CONCLUSIONS:
Refer to PubMed: http://www.ncbi.nlm.nih.gov/pubmed/14530023 Show less