Patrick M McCarthy

Northwestern Memorial Hospital, Chicago, Illinois, United States

Are you Patrick M McCarthy?

Claim your profile

Publications (538)3122.77 Total impact

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND Suspected genetic causes for extracellular matrix (ECM) dysregulation in the ascending aorta in patients with bicuspid aortic valves (BAV) have influenced strategies and thresholds for surgical resection of BAV aortopathy. Using 4-dimensional (4D) flow cardiac magnetic resonance imaging (CMR), we have documented increased regional wall shear stress (WSS) in the ascending aorta of BAV patients. OBJECTIVES This study assessed the relationship between WSS and regional aortic tissue remodeling in BAV patients to determine the influence of regional WSS on the expression of ECM dysregulation. METHODS BAV patients (n 1⁄4 20) undergoing ascending aortic resection underwent pre-operative 4D flow CMR to regionally map WSS. Paired aortic wall samples (i.e., within-patient samples obtained from regions of elevated and normal WSS) were collected and compared for medial elastin degeneration by histology and ECM regulation by protein expression. RESULTS Regions of increased WSS showed greater medial elastin degradation compared to adjacent areas with normal WSS: decreased total elastin (p 1⁄4 0.01) with thinner fibers (p 1⁄4 0.00007) that were farther apart (p 1⁄4 0.001). Multiplex protein analyses of ECM regulatory molecules revealed an increase in transforming growth factor b-1 (p 1⁄4 0.04), matrix metalloproteinase (MMP)-1 (p 1⁄4 0.03), MMP-2 (p 1⁄4 0.06), MMP-3 (p 1⁄4 0.02), and tissue inhibitor of metalloproteinase-1 (p 1⁄4 0.04) in elevated WSS regions, indicating ECM dysregulation in regions of high WSS. CONCLUSIONS Regions of increased WSS correspond with ECM dysregulation and elastic fiber degeneration in the ascending aorta of BAV patients, implicating valve-related hemodynamics as a contributing factor in the development of aortopathy. Further study to validate the use of 4D flow CMR as a noninvasive biomarker of disease progression and its ability to individualize resection strategies is warranted. (J Am Coll Cardiol 2015;66:892–900) © 2015 by the American College of Cardiology Foundation.
    Journal of the American College of Cardiology 08/2015; 66(8):892-90. · 15.34 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Suspected genetic causes for extracellular matrix (ECM) dysregulation in the ascending aorta in patients with bicuspid aortic valves (BAV) have influenced strategies and thresholds for surgical resection of BAV aortopathy. Using 4-dimensional (4D) flow cardiac magnetic resonance imaging (CMR), we have documented increased regional wall shear stress (WSS) in the ascending aorta of BAV patients. This study assessed the relationship between WSS and regional aortic tissue remodeling in BAV patients to determine the influence of regional WSS on the expression of ECM dysregulation. BAV patients (n = 20) undergoing ascending aortic resection underwent pre-operative 4D flow CMR to regionally map WSS. Paired aortic wall samples (i.e., within-patient samples obtained from regions of elevated and normal WSS) were collected and compared for medial elastin degeneration by histology and ECM regulation by protein expression. Regions of increased WSS showed greater medial elastin degradation compared to adjacent areas with normal WSS: decreased total elastin (p = 0.01) with thinner fibers (p = 0.00007) that were farther apart (p = 0.001). Multiplex protein analyses of ECM regulatory molecules revealed an increase in transforming growth factor β-1 (p = 0.04), matrix metalloproteinase (MMP)-1 (p = 0.03), MMP-2 (p = 0.06), MMP-3 (p = 0.02), and tissue inhibitor of metalloproteinase-1 (p = 0.04) in elevated WSS regions, indicating ECM dysregulation in regions of high WSS. Regions of increased WSS correspond with ECM dysregulation and elastic fiber degeneration in the ascending aorta of BAV patients, implicating valve-related hemodynamics as a contributing factor in the development of aortopathy. Further study to validate the use of 4D flow CMR as a noninvasive biomarker of disease progression and its ability to individualize resection strategies is warranted. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    Journal of the American College of Cardiology 08/2015; 66(8):892-900. DOI:10.1016/j.jacc.2015.06.1310 · 15.34 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study is to compare aortic hemodynamics and blood flow patterns using in-vivo four-dimensional (4D) flow magnetic resonance imaging (MRI) in patients after valve-sparing aortic root replacement (VSARR) and aortic root replacement with bioprosthetic valves (BIO-ARR). In-vivo 4D flow MRI was performed in 11 patients after VSARR (47 ± 18 years, 6 bicuspid aortic valves, 5 trileaflet aortic valves), 16 patients after BIO-ARR (52 ± 14 years), and 10 healthy controls (47 ± 16 years). Analysis included three-dimensional blood flow visualization and grading of helix flow in the ascending aorta (AAo) and arch. Peak systolic velocity was quantified in 9 analysis planes in the AAo, aortic arch, and descending aorta. Flow profile uniformity was evaluated in the aortic root and ascending aorta. Peak systolic velocity (2.0 to 2.5m/second) in the aortic root and AAo in both VSARR and BIO-ARR were elevated compared with controls (1.1 to 1.3m/second, p < 0.005). Flow asymmetry in BIO-ARR was increased compared with VSARR, evidenced by more AAo outflow jets (9 of 16 BIO-ARR, 0 of 11 in VSARR). The BIO-ARR exhibited significantly (p < 0.001) increased helix flow in the AAo as a measure of increased flow derangement. Finally, peak systolic velocities were elevated at the aortic root for BIO-ARR (2.5 vs 2.0m/second, p < 0.05) but lower in the distal AAo when compared with VSARR. The VSARR results in improved hemodynamic outcomes when compared with BIO-ARR, as indicated by reduced peak velocities in the aortic root and less helix flow in the AAo by 4D flow MRI. Longitudinal research assessing the clinical impact of these differences in hemodynamic outcomes is warranted. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
    The Annals of thoracic surgery 07/2015; DOI:10.1016/j.athoracsur.2015.04.109 · 3.65 Impact Factor
  • Patrick M McCarthy
    The Journal of thoracic and cardiovascular surgery 07/2015; DOI:10.1016/j.jtcvs.2015.07.007 · 3.99 Impact Factor
  • Source
    Journal of the American College of Cardiology 06/2015; 65(25):2767-8. DOI:10.1016/j.jacc.2015.04.034 · 15.34 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The study objectives were to (1) compare the safety of high-risk surgical aortic valve replacement in the Placement of Aortic Transcatheter Valves (PARTNER) I trial with Society of Thoracic Surgeons national benchmarks; (2) reference intermediate-term survival to that of the US population; and (3) identify subsets of patients for whom aortic valve replacement may be futile, with no survival benefit compared with therapy without aortic valve replacement. From May 2007 to October 2009, 699 patients with high surgical risk, aged 84 ± 6.3 years, were randomized in PARTNER-IA; 313 patients underwent surgical aortic valve replacement. Median follow-up was 2.8 years. Survival for therapy without aortic valve replacement used 181 PARTNER-IB patients. Operative mortality was 10.5% (expected 9.3%), stroke 2.6% (expected 3.5%), renal failure 5.8% (expected 12%), sternal wound infection 0.64% (expected 0.33%), and prolonged length of stay 26% (expected 18%). However, calibration of observed events in this relatively small sample was poor. Survival at 1, 2, 3, and 4 years was 75%, 68%, 57%, and 44%, respectively, lower than 90%, 81%, 73%, and 65%, respectively, in the US population, but higher than 53%, 32%, 21%, and 14%, respectively, in patients without aortic valve replacement. Risk factors for death included smaller body mass index, lower albumin, history of cancer, and prosthesis-patient mismatch. Within this high-risk aortic valve replacement group, only the 8% of patients with the poorest risk profiles had estimated 1-year survival less than that of similar patients treated without aortic valve replacement. PARTNER selection criteria for surgical aortic valve replacement, with a few caveats, may be more appropriate, realistic indications for surgery than those of the past, reflecting contemporary surgical management of severe aortic stenosis in high-risk patients at experienced sites. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
    The Journal of thoracic and cardiovascular surgery 06/2015; DOI:10.1016/j.jtcvs.2015.05.073 · 3.99 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Paravalvular regurgitation is a known complication after transcatheter and sutureless aortic valve replacement. Paravalvular regurgitation also may develop in patients undergoing percutaneous mitral valve replacement. There are few studies on contemporary surgical valve replacement for comparison. We sought to determine the contemporary occurrence of paravalvular regurgitation after conventional surgical valve replacement. We performed a single-center retrospective database review involving 1774 patients who underwent valve replacement surgery from April 2004 to December 2012: aortic in 1244, mitral in 386, and combined aortic and mitral in 144. Follow-up echocardiography was performed in 73% of patients. Patients with endocarditis were analyzed separately from noninfectious paravalvular leaks. Statistical comparisons were performed to determine differences in paravalvular regurgitation incidence and survival. During follow-up, 1+ or greater (mild or more) paravalvular regurgitation occurred in 2.2% of aortic cases and 2.9% of mitral cases. There was 2+ or greater (moderate or more) paravalvular regurgitation in 0.9% of aortic and 2.2% of mitral cases (P = .10). After excluding endocarditis, late noninfectious regurgitation 2+ or greater was detected in 0.5% of aortic and 0.4% of mitral cases (P = .93); there were no reoperations or percutaneous closures for noninfectious paravalvular regurgitation. In an academic medical center, the overall rate of paravalvular regurgitation is low, and late clinically significant noninfectious paravalvular regurgitation is rare. The benchmark for paravalvular regurgitation after conventional valve replacement is high and should be considered when evaluating patients for transcatheter or sutureless valve replacement. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
    The Journal of thoracic and cardiovascular surgery 06/2015; DOI:10.1016/j.jtcvs.2015.06.047 · 3.99 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Gender disparities in short- and long-term outcomes have been documented in cardiac and valvular heart surgery. However, there is a paucity of data regarding these differences in the bicuspid aortic valve (BAV) population. The aim of this study was to examine gender-specific differences in short- and long-term outcomes after surgical aortic valve (AV) replacement in patients with BAV. A retrospective analysis was performed in 628 consecutive patients with BAV who underwent AV surgery from April 2004 to December 2013. To reduce bias when comparing outcomes by gender, propensity score matching obtained on the basis of potential confounders was used. Women with BAV who underwent AV surgery presented with more advanced age (mean 60.7 ± 13.8 vs 56.3 ± 13.6 years, p <0.001) and less aortic regurgitation (29% vs 44%, p <0.001) and had a higher risk for in-hospital mortality (mean Ambler score 3.4 ± 4.4 vs 2.5 ± 4.0, p = 0.015). After propensity score matching, women received more blood products postoperatively (48% vs 34%, p = 0.028) and had more prolonged postoperative lengths of stay (median 5 days [interquartile range 5 to 7] vs 5 days [interquartile range 4 to 6], p = 0.027). Operative, discharge, and 30-day mortality and overall survival were not significantly different. In conclusion, women with BAV who underwent AV surgery were older, presented with less aortic regurgitation, and had increased co-morbidities, lending higher operative risk. Although women received more blood products and had significantly longer lengths of stay, short- and long-term outcomes were similar. Copyright © 2015 Elsevier Inc. All rights reserved.
    The American journal of cardiology 04/2015; DOI:10.1016/j.amjcard.2015.04.017 · 3.43 Impact Factor
  • Patrick M McCarthy
    Journal of the American College of Cardiology 04/2015; 65(18). DOI:10.1016/j.jacc.2015.01.058 · 15.34 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cardiac papillary fibroelastoma is a rare, benign tumor, arising predominantly from cardiac valves. This tumor can cause a variety of symptoms due to thromboembolism. We describe our single-center surgical experience with papillary fibroelastoma of the aortic valve. From April 2004 through June 2013, 6,530 patients underwent cardiac surgery. Of those, 6,098 patients were included in the final analysis. Twenty-one patients (0.34%) underwent surgical resection of 30 papillary fibroelastomas of the aortic valve. Most patients (67%) were incidentally diagnosed to have cardiac papillary fibroelastoma. The usual symptom was cerebral infarction (in 5 of 7 symptomatic patients). A rare presentation of papillary fibroelastoma in one patient was cardiac arrest caused by left main coronary artery ostial obstruction. Tumor size was not related to patient age (Pearson correlation coefficient, 0.34; P=0.13). Neither the number of tumors (1.43 ± 0.72 vs 1.43 ± 0.62) nor tumor size (8.14 ± 2.42 vs 8.07 ± 3.31 mm) was significantly different between symptomatic and asymptomatic patients. All lesions were resected by means of the simple shave technique. There were no operative or 30-day deaths. Follow-up echocardiograms showed no tumor recurrence (mean follow-up duration, 17 ± 14 mo). We identified no significant relationship among tumor size, number of tumors, symptoms, or patient age. Because simple shave excision of the tumor can be safely achieved without evidence of tumor recurrence, we conclude that surgical resection can be reasonable in asymptomatic patients.
    Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 04/2015; 42(2):131-5. DOI:10.14503/THIJ-14-4262 · 0.63 Impact Factor
  • 04/2015; 3(4):343-4. DOI:10.1016/j.jchf.2014.12.011
  • [Show abstract] [Hide abstract]
    ABSTRACT: Post-surgical late reinterventions for atrial fibrillation (AF) include cardioversions (CV) or catheter ablations (CA). Commonly used methods for reporting and modeling the frequency and timing of CA or CV have well-known shortcomings. Intuitive and robust methods to visualize, summarize and model late reinterventions type/timing and vital status simultaneously are presented. We present (1) the SMART plot (Summary of Mortality And Outcomes Reported Over Time); (2) the reintervention mean cumulative function (MCF); (3) the proportional means model and the proportional rates model. We illustrate these methods in three groups: patients age ≤ 60, 60 to 75 (reference) and > 75 years who underwent surgical AF ablation. Patients age > 75 years had a significantly lower MCF of CVs (hazard ratio (HR) =0.50, p < 0.001). The MCF for CAs was not significantly lower for patients age > 75 (HR = 0.57, p=0.13). For combined reinterventions (CV or CA), the age > 75 years group had a significantly lower MCF (HR=0.51, p< 0.001). There were no significant differences in late CV or CA reintervention patterns for patients age ≤ 60 years. Methods presented provide a comprehensive framework for displaying, summarizing and modeling repeated late reinterventions after surgical AF ablation. Other areas of application are described, thus further emphasizing the potential for immediate use. Copyright © 2015. Published by Elsevier Inc.
    Heart rhythm: the official journal of the Heart Rhythm Society 03/2015; DOI:10.1016/j.hrthm.2015.03.062 · 4.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A hemiarch reconstruction, using deep hypothermic circulatory arrest, is the conventional approach for proximal aortic arch reconstruction, but it carries risks of neurologic events and coagulopathy. The addition of a hemiarch reconstruction to an aortic root replacement may prevent future aortic arch pathology. Outcomes of this approach at a tertiary care institution were examined to determine whether the addition of a hemiarch reconstruction to an aortic root replacement conferred any additional risk. A total of 384 patients underwent an aortic root replacement between April 2004 and June 2012. Of them, 177 (46%) had hemiarch replacement. Propensity score matching yielded 133 pairs of patients receiving hemiarch and non-hemiarch. Sinus segment diameter was similar between groups; ascending aortic diameter was greater in the hemiarch group (median 50 vs 44 mm; P < .001). The hemiarch group had longer perfusion (median 186 vs 120.5 minutes; P < .001) and crossclamp times (median 140 vs 104 minutes; P < .001); median circulatory arrest was 13 minutes. There was no difference, hemiarch versus no hemiarch, in 30-day mortality (3.0% vs 1.5%; P = .41), stroke (2.3% vs 4.5%; P = .31), reoperation for bleeding (11% vs 10%; P = .84), or overall survival (5-year 88.0% [95% confidence interval, 81.9-94.0] vs 91.4% [95% confidence interval, 85.8-96.9], P = .24). In this series, aortic root replacement ± hemiarch reconstruction had low mortality. Addition of hemiarch replacement extended perfusion times but not at the expense of safety. Hemiarch reconstruction should be performed when the aortic root aneurysm extends into the distal ascending aorta. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
    The Journal of thoracic and cardiovascular surgery 03/2015; 150(1). DOI:10.1016/j.jtcvs.2015.03.020 · 3.99 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Secondary mitral regurgitation (MR) is associated with poor outcomes, but its correction does not reverse the underlying left ventricular (LV) pathology or improve the prognosis. The recently published American Heart Association/American College of Cardiology guidelines on valvular heart disease generated considerable controversy by revising the definition of severe secondary MR from an effective regurgitant orifice area (EROA) of 0.4 to 0.2 cm(2), and from a regurgitant volume (RVol) of 60 to 30 ml. This paper reviews hydrodynamic determinants of MR severity, showing that EROA and RVol values associated with severe MR depend on LV volume. This explains disparities in the evidence associating a lower EROA threshold with suboptimal survival. Redefining MR severity purely on EROA or RVol may cause significant clinical problems. As the guidelines emphasize, defining severe MR requires careful integration of all echocardiographic and clinical data, as measurement of EROA is imprecise and poorly reproducible. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    Journal of the American College of Cardiology 12/2014; 64(25):2792-2801. DOI:10.1016/j.jacc.2014.10.016 · 15.34 Impact Factor
  • Patrick M McCarthy
    Journal of Thoracic and Cardiovascular Surgery 12/2014; 148(6):2750-1. DOI:10.1016/j.jtcvs.2014.10.071 · 3.99 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the impact of aortic valve morphology on aortic hemodynamics between normal tricuspid and congenitally anomalous aortic valves ranging from unicuspid to quadricuspid morphology. Aortic three-dimensional (3D) blood flow was evaluated by 4D flow MRI in 14 healthy volunteers with normal trileaflet valves and 14 patients with unicuspid (n = 3), bicuspid (n = 9, 3 "true" bicuspid, 3 right-left (RL), 3 right-noncoronary (RN) leaflet fusion, and quadricuspid aortic valves (n = 2). Data analysis included the co-registered visualization of aortic valve morphology with systolic 3D blood flow. The influence of valve morphology on aortic hemodynamics was quantified by valve flow angle. All RL-bicuspid aortic valve (BAV) were associated with flow jets directed toward the right anterior aortic wall while RN-fusion and unicuspid valves resulted in flow jet patterns toward the right-posterior or posterior wall. Flow angles were clearly influenced by valve morphology (47° ± 10, 28° ± 2, 29° ± 18, 18° ± 12, 15° ± 2 for unicuspid, true BAV, RN-BAV, RL-BAV, quadricuspid valves) and increased compared with controls (7.2° ± 1.1, P = 0.001). Altered 3D aortic hemodynamics are impacted by the morphology of congenitally malformed aortic valves.J. Magn. Reson. Imaging 2013. © 2013 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 12/2014; 40(6). DOI:10.1002/jmri.24498 · 2.79 Impact Factor
  • Source
    Circulation 11/2014; 130(19):e171. DOI:10.1161/CIRCULATIONAHA.114.010928 · 14.95 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The study sought to assess feasibility, safety, and potential efficacy of a novel implantable extra-aortic counterpulsation system (C-Pulse) in functional class III and ambulatory functional class IV heart failure (HF) patients. Background: 30% to 40% of HF patients suffer from poor functional status and quality of life (QoL) but are not inneed of end-stage treatments. We undertook a multicenter single-arm study to assess the C-Pulse System in such patients. Methods: New York Heart Association (NYHA) functional class III or ambulatory functional class IV HF patients were eligible. Safety was assessed continuously through 12 months. Efficacy measurements included changes from baseline to6 and 12 months in NYHA functional class, Minnesota Living with Heart Failure (MLWHF) and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores, 6-min walk distance (6MWD), and exercise peak oxygen consumption (pVO2; 6months only). Results: Twelve men and 8 women (56.7 ± 7 years, 34 to 71 years of age) with ischemic (n= 7) or nonischemic (n= 13) cardiomyopathy were implanted. There was no 30-day mortality and no neurological events or myocardial infarctions through 12 months. At 6 months, there were 3 deaths (1 device-related). One-year survival was 85%. At 6 months, C-Pulse produced improvements in NYHA functional class (3.1 ± 0.3 to 1.9 ± 0.7, p= 0.0005), MLWHF (63.6 ± 19.9 to 40.2 ± 23.2, p= 0.0005), and KCCQ scores (43.6 ± 21.1 to 65.6 ± 21.5, p= 0.0002), but not 6MWD (275.5 ± 64.0 to 296.4 ± 104.9, p = NS) or pVO2 (14.5 ± 3.6 to 13.1 ± 4.4, p = NS). Improvements continued at 12 months, with 6MWD change becoming statistically significant (336.5 ± 91.8, p= 0.0425). Conclusions: Use of C-Pulse in this population is feasible, appears safe, and improves functional status and QoL. Aprospective, multicenter, randomized controlled trial is underway. (C-Pulse IDE Feasability Study-A Heart Assist System; NCT00815880).
    JACC: Heart Failure 10/2014; 2(5):526-33. DOI:10.1016/j.jchf.2014.04.014
  • The Canadian journal of cardiology 10/2014; 30(10):S140. DOI:10.1016/j.cjca.2014.07.200 · 3.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background. Severe symptomatic aortic stenosis (AS) is associated with high mortality without intervention. The impact of waiting time for aortic valve replacement (AVR), either surgically or transcatheter, has not been reported. Methods. From January 2008 to December 2012, we identified 1,005 patients with severe symptomatic AS. AVR was recommended for 823 patients (82%). Of these 823 patients, 721 (87.6%) underwent AVR. We modeled overall survival (OS) since AVR recommendation or intervention date using Cox and multistate models. Results. Overall, the median (first, third quartiles) waiting time until operation was 2.9 (1.3, 5.1) weeks. Mortality at these times was lower (p < 0.001) in the AVR group (1.2%, 0.3%, 1.7%, respectively) than in the group that did not receive AVR (6.9%, 2.9%, 9.8%, respectively). Thirty-day mortality after AVR was 3.9% (3.2% surgical AVR [SAVR] and 7.0% transcatheter AVR [TAVR]). In patients receiving AVR, waiting time was not associated with increased mortality. Mortality while waiting for AVR was 3.7% and 11.6% at 1 and 6 months, respectively. Mortality while waiting for TAVR was higher than that for SAVR (1-, 6-, and 12-month mortality of 3.7%, 8.0%, and 9.6%, respectively, in SAVR group and 3.8%, 23.3%, and 27.5%, respectively, in TAVR group; p < 0.001). Conclusions. Some patients do not receive AVR in a timely fashion, and prolonged waiting time for AVR is associated with mortality greater than the AVR operative mortality. Although waiting time was not associated with poor operative outcomes after AVR, many patients may die while waiting for AVR. Patients should receive AVR on a semiurgent, not elective, basis. (C) 2014 by The Society of Thoracic Surgeons
    The Annals of Thoracic Surgery 09/2014; 98(5). DOI:10.1016/j.athoracsur.2014.06.040 · 3.63 Impact Factor

Publication Stats

18k Citations
3,122.77 Total Impact Points

Institutions

  • 2005–2015
    • Northwestern Memorial Hospital
      • • Department of Surgery
      • • Bluhm Cardiovascular Institute
      Chicago, Illinois, United States
    • Northwestern University
      • • Division of Thoracic Surgery
      • • Division of Cardiac Surgery
      • • Department of Surgery
      • • Feinberg School of Medicine
      • • Bluhm Cardiovascular Institute
      Evanston, Illinois, United States
    • Rice University
      • Department of Bioengineering
      Houston, TX, United States
  • 2013
    • University of Washington Seattle
      Seattle, Washington, United States
  • 2012
    • Johns Hopkins Medicine
      Baltimore, Maryland, United States
  • 2005–2011
    • University of Illinois at Chicago
      Chicago, Illinois, United States
  • 2007
    • Cleveland Clinic Laboratories
      Cleveland, Ohio, United States
  • 2001–2006
    • Lerner Research Institute
      Cleveland, Ohio, United States
    • University of California, Los Angeles
      • Department of Psychology
      Los Angeles, California, United States
  • 1993–2004
    • Cleveland Clinic
      • Department of Cardiology
      Cleveland, Ohio, United States
  • 2003
    • University of Florida Health Science Center-Jacksonville
      Jacksonville, Florida, United States
    • Stanford University
      • Division of Cardiovascular Medicine
      Palo Alto, California, United States
  • 2002
    • Cleveland State University
      • Department of Biological, Geological, and Environmental Sciences
      Cleveland, Ohio, United States
    • Wake Forest University
      Winston-Salem, North Carolina, United States
  • 2001–2002
    • Università degli Studi dell'Aquila
      • Department of Internal Medicine and Public Health
      Aquila, Abruzzo, Italy
  • 2000
    • Children's Heart Center
      Las Vegas, Nevada, United States
  • 1999
    • Ochsner
      • Department of Cardiology
      New Orleans, LA, United States
  • 1993–1999
    • The Ohio State University
      • Department of Biomedical Engineering
      Columbus, Ohio, United States
  • 1996
    • Lexington Medical Center
      West Columbia, South Carolina, United States
  • 1995
    • Case Western Reserve University
      • Department of Macromolecular Science and Engineering
      Cleveland, OH, United States