David Schibilsky

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Verified

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• M.D.
• Surgeon at Luzerner Kantonsspital

A driveline exit site infection is a serious and common complication in long-term left ventricular assist device (LVAD) support. To reduce the incidence and severity of late driveline infections, we modified our surgical technique (double tunnel), and compared it to the conventional short and straight driveline tunnel technique (conventional). We a...

The hemocompatible properties of rotary blood pumps commonly used in mechanical circulatory support (MCS) are widely unknown regarding specific biocompatibility profiles of different pump technologies. Therefore, we analyzed the hemocompatibility indicating markers of an axial flow and a magnetically levitated centrifugal device within an in vitro...

Objectives: The aim of this study was to analyse the influence of varying experiences within each surgical team to identify team-related risk factors on clinical outcomes after total aortic arch replacement. Methods: Each surgeon was rated from 1 to 5, and a surgical team's score was calculated (operating surgeon + assisting surgeon = team score...

The first prototype of an adapter to enable left ventricular assist device (LVAD) implantation solely via the left ventricular (LV) apex and without requiring cardiopulmonary bypass (CPB) was tested in healthy and acutely failing pig hearts. The adapter consists of a fixation, blood guiding, and connecting module fitting to a HeartMate 3 (HM3; Abbo...

Background The relevance of cold agglutinins in lung transplantation (LTx) recipients is unclear. While there is typically no intentionally induced hypothermia, the cold preservation of organs could potentially lead to microvascular injury and vascular occlusion after implantation and reperfusion in the presence of cold agglutinins. This study aims...

Left ventricular assist device (LVAD) outflow graft obstruction (OGO) is a serious complication that often requires surgical intervention. Standard approaches involve cardiopulmonary bypass (CPB) or veno-arterial extracorporeal membrane oxygenation (vaECMO) to facilitate outflow graft clamping and shortening. We present a surgical approach to reduc...

Background Lung transplantation (LTx) remains the only efficient treatment for selected patients with end-stage pulmonary disease. The age limit for the acceptance of donor organs in LTx is still a matter of debate. We here analyze the impact of donor organ age and the underlying pulmonary disease on short- and long-term outcome and survival after...

Background In conventional left ventricular assist devices (LVAD), a separate outflow graft is sutured to the ascending aorta. Novel device designs may include a transventricular outflow cannula crossing the aortic valve (AV). While transversal ventricular dimensions are well investigated in patients with severe heart failure, little is known about...

Objectives To determine the diagnostic accuracy of ultra-high-resolution photon-counting detector CT angiography (UHR PCD-CTA) for evaluating coronary stent patency compared to invasive coronary angiography (ICA). Methods Consecutive, clinically referred patients with prior coronary stent implantation were prospectively enrolled between August 202...

Objectives: Durable mechanical circulatory support system (MCS) after (extra-corporeal Life Support (ECLS) registry is a multicenter registry of patients who were bridged from ECLS to durable MCS. While numerous studies have highlighted the favorable outcomes following HeartMate 3 (HM3) implantation, the objective of our study is to examine the ou...

Background and objectives: The treatment of pathologies of the aortic arch is a complex field of cardiovascular surgery that has witnessed enormous progress recently. Such treatment is mainly performed in high-volume centres, and surgeons gain great experience in mastering potential difficulties even under emergency circumstances, thereby ensuring...

Background Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO duri...

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO dur...

Background The HeartMate 3 (HM 3) left ventricular assist device (LVAD) has improved hemocompatibility-related adverse outcomes. In sporadic cases, external compression of the outflow graft causing obstruction (eOGO) can result from substance accumulation between the outflow graft and its bend relief. We sought to evaluate the prevalence, course, a...

Insufficient unloading of the left ventricle during mechanical circulatory support by venoarterial ECLS constitutes a major clinical problem, which is difficult to predict. The integration of a surgical venting catheter within the venous part of the ECLS system represents a major intervention in the system with potential risks, such as air embolism...

Objectives Cardiac support systems are being used increasingly more due to the growing prevalence of heart failure and cardiogenic shock. Reducing cardiac afterload, intracardiac pressure, and flow support are important factors. Extracorporeal membrane oxygenation (ECMO) and intracardiac microaxial pump systems (Impella) as non-permanent MCS (mecha...

The treatment of patients with advanced heart failure requires interdisciplinary care in a qualified heart failure team, especially prior to and in the follow-up of mechanical circulatory support (MCS) implantation and heart transplantation (HTx). The basic prerequisite is the early specialized evaluation of symptomatic patients even under optimize...

The treatment of patients with advanced heart failure requires interdisciplinary care in a qualified heart failure team, especially prior to and in the follow-up of mechanical circulatory support (MCS) implantation and heart transplantation (HTx). The basic prerequisite is the early specialized evaluation of symptomatic patients even under optimize...

The treatment of patients with advanced heart failure requires interdisciplinary care in a qualified heart failure team, especially prior to and in the follow-up of mechanical circulatory support (MCS) implantation and heart transplantation (HTx). The basic prerequisite is the early specialized evaluation of symptomatic patients even under optimize...

Stroke is one of the leading complications following durable mechanical circulatory support (MCS) implantation. The aim of this multicenter study was to investigate stroke complications in patients requiring durable MCS following extracorporeal life support (ECLS). Data of 11 high volume MCS centers were collected and evaluated to identify patients...

Purpose The HeartMate3 (HM3) left ventricular assist device (LVAD) has markedly improved hemocompatibility related adverse outcomes. In sporadic cases, external compression of the outflow graft causing obstruction (eOGO) can result from gelatinous substance accumulation between outflow graft and its bend relief covering. We sought to evaluate the p...

Objective: Ex vivo organ perfusion is an advanced preservation technique that allows graft assessment and extended ex situ intervals. We hypothesized that its properties might be especially beneficial for high-risk recipients and/or donors with extended criteria. Methods: We reviewed the outcomes of 119 consecutive heart transplant patients, which...

OBJECTIVES To evaluate outcomes after thoracic endovascular aortic repair in young patients sustaining traumatic blunt aortic injury (BAI) using iliac extension stent-grafts because of small aortic diameters measuring <24 mm. METHODS Retrospective analysis regarding clinical presentation, trauma management, endovascular techniques and outcome of p...

Aims Ventricular assist device (VAD) implantation has become a well-established treatment strategy for patients suffering from advanced heart failure. Ventricular assist device treatment attempts to ameliorate the symptom burden but may create new challenges in patients’ lives. Lacking are insights into perceived challenges and health-related needs...

OBJECTIVES Implanting a durable left ventricular assist device (LVAD) in a patient on extracorporeal life support (ECLS) is challenging. The goal of this study was to compare the results of patients from a European registry who had a durable LVAD implanted with or without transition from ECLS to cardiopulmonary bypass (CPB). METHODS A total of 531...

Background: The literature on outcomes of patients requiring durable mechanical circulatory support (MCS) after extra-corporeal life support (ECLS) is limited. The aim of this study was to investigate the impact of preoperative ECLS cannulation on postoperative outcome after durable MCS implantation. Methods: The durable MCS after ECLS registry...

Purpose Neurological complications are considered as most frequent complications following left ventricular device device (VAD) implantation. The aim of this multicenter study is to investigate neurological complications in patients requiring durable VADs following extra-corporeal life support (ECLS) implantation. Methods Data of eleven high volum...

Background The Abiomed Impella 5.5 (Danvers, MA) is a newly developed axial flow transaortic cardiac support device mounted on a 9 Fr steering catheter with a 21 Fr pump cannula. Impella 5.5 is intended for longer use and was approved for 30 days in 2018. This study evaluated the first-in-man series at six high-volume mechanical circulatory support...

Even with current generation mechanical circulatory support (MCS) devices, vascular complications are still considerable risks in MCS that influence patients’ recovery and survival. Hence, efforts are made to reduce vascular trauma and obtaining safe and adequate arterial access using state-of-the-art techniques is one of the most critical aspects...

Cardiogenic shock is a highly lethal syndrome, leading to rapid death or secondary multiorgan damage, but current shock therapies, including mechanical support devices, also have a significant side effect profile. The overarching goal of shock therapy is ensuring long-term survival with good quality of life. This implies averting death, modifying t...

Background: The aim of this study was to evaluate the impact of the surgical approach on the postoperative outcome in patients who underwent left ventricular assist device (LVAD) implantation after having received veno-arterial extracorporeal life support (va-ECLS) using data from a European registry (ECLS-VAD). Five hundred and thirty-one patient...

Background Pediatric heart transplant (HTx) recipients with congenital heart defects require complex concomitant surgical procedures with the risk of prolonging the allograft’s ischemic time. Ex- vivo allograft perfusion with the Organ Care System (OCS) may improve survival of these challenging patients. Methods Retrospective, single center study....

Tracheomalacia in Straight Back Syndrome (SBS) results from chronic compression of the trachea and the mainstem bronchi mainly due to decreased mediastinal diameter. Mainstay of correction is the increase of mediastinal space and the restoration of the tracheal lumen and stability. Due to the great variability of the manifestation of this disease,...

Blood flow through left ventricular assist devices (LVAD) may induce activation and dysfunction of platelets. Dysfunctional platelets cause coagulation disturbances and form platelet-neutrophil conjugates (PNC), which contribute to inflammatory tissue damage. This prospective observational cohort study investigated patients, who underwent implantat...

The specific hemocompatibility properties of mechanical-circulatory-support (MCS)-pump technologies have not previously been described in a comparable manner. We thus investigated the hemocompatibility-indicating marker of a new magnetically-levitated (MagLev) centrifugal pump (MT-Mag) in a human, whole-blood mock-loop for 360 min using the MCS dev...

Background The decision to implant durable mechanical circulatory systems (MCSs) in patients on extracorporeal life support (ECLS) is challenging due to expected poor outcomes in these patients. Objectives The aim of this study was to identify outcome predictors that may facilitate future patient selection and decision making. Methods The Durable...

To describe the incidence, therapy and outcome of traumatic tracheobronchial injuries (TTBI) in trauma patients with multiple injuries derived from the DGU TraumaRegister. We analyzed the data on all patients listed on the TraumaRegister DGU (TR-DGU) in Germany between 2002 and 2015 aged 16 years or older and with an Injury Severity Score (ISS) of...

Purpose Currently the implantation of left-ventricular assist devices (LVADs) requires the use of cardiopulmonary bypass (CPB) and access to the aorta for the placement of the in-and outflow, respectively. We designed an adapter to allow minimally-invasive LVAD implantation through the LV apex without the use of CPB by fusing in- and outflow into a...

Purpose The Abiomed Impella 5.5 (Danvers, MA), is a newly developed axial flow trans-aortic cardiac support device mounted on a 9 Fr steering catheter with a 21 Fr pump cannula. The Impella 5.5 is intended for longer use and received in 2018 CE mark for 30 days. This study evaluates the first-in-man series from six high volume mechanical circulator...

Purpose Ex vivo heart perfusion is an innovative preservation technique, that permits graft assessment and extended out-of-body intervals. In times of high-risk recipients and donors with extended criteria, we hypothesized that its properties for prolonged heart preservation might be especially beneficial. Methods We reviewed the outcome of 76 end...

Purpose Many surgeons prefer to use cardiopulmonary bypass (CPB) machine when durable ventricular assist devices (VAD) is implanted in patients on veno-arterial membrane oxygenation (VA-ECMO). The aim of this study was to investigate if omitting CPB machine at the time of surgery negatively influence the outcome. Methods Data of eleven high volume...

Purpose The Organ Care System (OCS) Heart® is non-inferior to standard cold storage for preservation of donor hearts. We hypothesized that its properties for prolonged heart preservation might be especially beneficial for extended criteria donor (ECD) hearts. Methods Patients transplanted with ECD hearts preserved using the OCS Heart® at two Germa...

Purpose Patients on veno-arterial membrane oxygenation (VA-ECMO) are high-risk candidates for durable ventricular assist device (VAD) surgery. The aim of this study was to compare the outcome of patients who received durable VAD on VA-ECMO using less invasive (LIS) vs. sternotomy approach. Methods Data of eleven high volume VA-ECMO/VAD centers are...

The novel coronavirus SARS-CoV-2 is infecting hundreds of thousands of humans around the globe. The coronavirus disease COVID-19 is known to generate mild as well as critical courses. Complications on the intensive care units include acute respiratory distress syndrome, acute cardiac- and kidney injury as well as shock.Here, we present the first ca...

Aims Sufficient myocardial recovery with the subsequent explantation of a left ventricular assist device (LVAD) occurs in approximately 1–2% of the cases. However, follow‐up data about this condition are scarcely available in the literature. This study aimed to report the long‐term outcomes and clinical management following LVAD explantation. Meth...

Objectives: Extracorporeal membrane oxygenation is used to stabilize severe cardiocirculatory and/or respiratory failure. However, extracorporeal membrane oxygenation is associated with a coagulopathy characterized by thromboembolic and hemorrhagic complications. This study aimed to characterize the pathomechanism of the extracorporeal membrane ox...

Heart failure has remained the leading cause of death globally for the last 15 years-and its prevalence will continue to rise. Fifty years ago, heart failure management was enriched by the possibility of a heart transplant. Despite impressive improvements in medical treatment for heart failure, a heart transplant remains the most effective long-las...

Purpose In patients supported by a left ventricular assist device (LVAD) myocardial recovery resulting in explant occurs in approximately 1-2%. However, the long-term outcome of these patients is unknown. We studied the clinical management and long-term outcomes in patients after LVAD explant. Methods An analysis of the European Registry for Pati...

Purpose Ex vivo organ perfusion is an advanced preservation technique that allows graft assessment and extended ex situ intervals. We hypothesized that its properties for prolonged heart preservation might be especially beneficial for high risk recipients. Methods We reviewed the 1-year-outcome of 126 end-stage heart failure patients that underwen...

Purpose The implantation of durable ventricular assist devices (VAD) in patients on veno-arterial membrane oxygenation (VA-ECMO) is controversial. Available studies in this field are limited to anecdotal case reports. In this study, data of ten high volume VA-ECMO/VAD centers are collected and analysed. Methods Following approval from correspondin...

Purpose To describe technical aspects of angiography and intravascular ultrasound (IVUS) in ex-vivo perfused hearts using the Organ Care System (OCS, TransMedics, Andover, MA USA). Methods During ex-vivo perfusion of a pig heart a moderate stenosis of the mid left anterior descending coronary artery (LAD) was created in order to test the sensitivi...

Purpose To describe the outcome of VAD implantation with respect to the clinical status and the presence of temporary mechanical circulatory support (tMCS) prior to VAD implantation. Methods We analysed all patients from the EUROMACS database, with 1-year follow-up analysis and included 2571 patients. 2008 patients had no tMCS prior to implantatio...

Hintergrund Die extrakorporale kardiopulmonale Reanimation (eCPR) ist Bestandteil der ERC-Reanimationsleitlinien 2015. Mit zunehmender Verfügbarkeit dieser Therapieoption besteht bei medizinischem Fachpersonal, das regelhaft in erweiterte Reanimationsmaßnahmen eingebunden ist, jedoch Unsicherheit hinsichtlich medizinischer und organisatorischer Fra...

Background: Right heart failure remains a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Multiple 2D echocardiography derived parameters are associated with right ventricular failure (RV failure), but none of them has been proven to be a reliable predictor to date. We hypothesized that novel 3D-ech...

Die Herztransplantation ist weiterhin der Goldstandard zur Therapie der fortgeschrittenen Herzinsuffizienz. In den vergangenen Jahrzehnten hat sich die Therapie stetig entwickelt, doch Organentnahme und -transport bleiben weitestgehend unverändert. Die normotherme Ex-vivo-Perfusion bietet eine neuartige Plattform für den Transport perfundierter Spe...

We report the use of out-of-hospital extracorporeal life support (ECLS) in a 62-year-old patient with severe cardiogenic shock after cardiac arrest. The patient was successfully stabilized using the ECLS system in the pre-hospital setting. Hospital discharge with a good neurological outcome was possible after 23 days.

Background: Heart transplantation (HTx) and implantable left ventricular assist systems (LVAS) improve outcomes in advanced heart failure but may be underutilized. We hypothesized that screening can identify appropriate candidates. Methods and results: The ScrEEning for advanced Heart Failure treatment (SEE-HF) study was a multicentre prospectiv...

P ercutaneous edge-to-edge mitral valve repair (PMVR) using the MitraClip system (Abbott Vascular) is an effective treatment option beyond medical therapy for patients with mitral regurgitation, who are not eligible for cardiac surgery.1 Previously, it was reported that patients with severely impaired left ventricular ejection function (<20%) may h...

Objectives: Moderate or severe degree tricuspid valve regurgitation (TVR) is associated with high rates of morbidity and mortality. Surgical correction as the only therapeutic option offers unsatisfactory results. Recently, several interventional procedures have been introduced clinically in a limited cohort. We present our initial experiments wit...

Background The objective of this study was to evaluate the outcome of left ventricular assist device (LVAD) implantation after initial extracorporeal life support (ECLS) in patients with cardiogenic shock and the incidence of post implantation right ventricular failure. Methods & results All patients on ECLS therapy for cardiogenic shock prior to...

Study data. De-identified complete dataset. (XLSX)

Objectives: We measured aortic dimensions, particularly length parameters, using 3D imaging with the aim of refining the risk-morphology for Stanford type A aortic dissection (TAD). Methods: Computer tomography angiography studies were analysed using the curved multiplanar reformats. At defined landmarks, the diameters and lengths of aortic segm...

New surgical techniques aim for less-invasive implantation of left ventricular assist devices (LVAD) via small surgical incision sites. Echocardiography plays an important role during patient selection and guidance of the procedure. The surgical incision site can be identified preoperatively by transthoracic echocardiography. Intraoperative identif...

Fragestellung: Kann eine präklinische Implantation eines extrakorporalen Herz-Kreislauf-Unterstützungssystems (ECLS) bei Patienten im kardiogenen Schock nach Reanimation das Überleben verbessern: ein Fallbericht. Einleitung: In den letzten 30 Jahren hat sich die Überlebensrate nach CPR nicht verändert. Auch die Mortalität im kardiogenen Schock ist...

The catheter-based Impella 5.0 left ventricular assist device is a powerful and less invasive alternative for patients in cardiogenic shock. The use as second-line therapy in patients with precedent extracorporeal life support (ECLS) has not been described before now. We analyzed our experience of consecutive patients treated with this alternative...

Thinking about the daily practice of cardiac surgery, genetically altered mouse models, polymerase chain reactions, western blots, and other laboratory tools are the last that comes to mind. It is, therefore, not surprising that the pursuit of such basic science activities by practicing surgeons and those in training is often limited. However, ther...

The catheter-based Impella 5.0 left ventricular assist device (LVAD) is a powerful and less invasive alternative for patients in cardiogenic shock. The use of this device as a primary mechanical circulatory support strategy in INTERMACS II patients should be evaluated. From April 2014 to August 2014, eight Impella 5.0 devices were implanted in seve...

We herein present a new surgical technique in the treatment of an anomalous left coronary artery from the right coronary sinus in an 18-year-old patient with an intramural course of the left main coronary artery. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.