Mark S Slaughter

• University of Louisville

Objectives The German Registry of Acute Aortic Dissection Type A (GERAADA) score is a risk score for predicting 30-day mortality after surgery for type A acute aortic dissection (TAAAD). This meta-analysis sought to assess the performance of the GERAADA model and compare it to the EuroSCORE II. Methods A systematic search of 3 online databases was...

This case series evaluated the characteristics and outcomes of reoperative root replacement in patients with prior aortic valve replacement (AVR), aortic root replacement (ARR), or ascending or hemiarch replacement (AoR) from our single institution from 2014 to 2023. A total of 55 (prior surgery: 38 AVR, 5 ARR, and 12 AoR) patients were identified...

Heart transplantation remains the primary treatment for biventricular heart failure, mechanical circulatory support (MCS) is often needed for stabilization to allow for clinical decision-making regarding candidacy for recovery, durable MCS, or transplant. Patients with isolated right ventricular failure or biventricular failure have higher mortalit...

Importance The advanced ambulatory heart failure (HF) population comprises patients who have progressed beyond the pillars of recommended stage C HF therapies but can still find meaningful life-years ahead. Although these patients are commonly encountered in practice, national databases selectively capture the small groups accepted for heart transp...

Our patient presented to the emergency room following a motor vehicle accident. The traumatic tricuspid valve rupture was diagnosed by transthoracic echocardiogram, and his respiratory status declined rapidly. He was placed on veno-venous extracorporeal membrane oxygenation (VV ECMO) to bridge him to surgical repair. Transoesophageal echocardiograp...

Objective Recent reports on ischemic mitral valve (MV) regurgitation surgical strategies have suggested better hemodynamic performance with MV replacement (MVR) than MV repair (MVr) with no survival difference at 2 years. We evaluated the difference between MVR and MVr outcomes in patients with ischemic MR, including hemodynamic MV performance at 1...

There is insufficient data on the outcomes of donation after circulatory death (DCD) multiorgan transplant that includes heart. The primary objective of this study is to compare the overall survival outcomes of DCD and donation after brain death (DBD) multiorgan transplants. We identified all heart transplant patients from 2019 to June of 2023 usin...

To address the clinical need for totally implantable mechanical circulatory support devices, Bionet Sonar is developing a novel Ultrasonic Transcutaneous Energy Transmission (UTET) system that is designed to eliminate external power and/or data communication drivelines. UTET systems were designed, fabricated, and pre-clinically tested using a non-c...

Background Takotsubo syndrome is being diagnosed more often with its increased recognition over the past 2 decades and with the availability of imaging such as point-of-care echocardiography and tissue characterization by cardiovascular magnetic resonance (CMR). Case summary A young man developed pericarditis and was treated with steroids. A few w...

CoRISMA MCS Systems Inc (Hamden CT) is developing an innovative mechanical circulatory support system (CMCS) as a durable therapeutic option for heart failure (HF) patients. The CMCS system is comprised of an axial flow pump, non-contacting hydrodynamic bearings, and integrated DC motor designed to be fully implantable in a left atrial (LA) to aort...

Background: Simultaneous heart-kidney transplantation (HKTx) represents guideline-directed treatment for heart failure with persistent irreversible renal dysfunction. However, persisting barriers hinder equitable access and influence post-transplant outcomes. We sought to determine socioeconomic disparities in post-transplant survival outcomes in p...

Mechanical unloading and circulatory support with left ventricular assist devices (LVADs) mediate significant myocardial improvement in a subset of advanced heart failure (HF) patients. The clinical and biological phenomena associated with cardiac recovery are under intensive investigation. Left ventricular (LV) apical tissue, alongside clinical da...

We characterize the anatomy and function of never before studied total artificial hearts (TAHs) using established methods for testing mechanical circulatory support (MCS) devices. A historical review of TAHs is also presented to aid in benchmarking performance metrics. Six TAHs, ranging from spooky Halloween beating hearts to a cute colorful plush...

OBJECTIVES Heart transplantation for adult congenital heart disease is complicated and associated with challenging pretransplant support, long waiting and high early post-transplant mortality. We explored if surgical and medical advances and allocation system changes have affected outcomes. METHODS From United Network for Organ Sharing database, a...

Penetrating cardiac injuries usually require emergent surgical intervention. Our patient presented to the trauma centre with multiple stab wounds to the neck, chest, epigastric region and abdomen. She arrived haemodynamically stable, and her initial Focused Assessment with Sonography for Trauma exam was negative. Her chest X-ray did not show any ev...

Background Aortic aneurysms involving the proximal aortic arch, which require hemiarch-type repair, typically require circulatory arrest with antegrade cerebral perfusion. Left carotid antegrade cerebral perfusion (LCP) via distal arch cannulation without circulatory arrest was used in this study’s patient population. The goal was to assess the ope...

There has been an increase in the use of extracorporeal membrane oxygenation (ECMO) to bridge critically ill patients to lung transplant (LTX). This study evaluates how ambulatory status on ECMO affected waitlist and post-LTX outcomes. The United Network of Organ Sharing (UNOS) database was queried for patients aged of greater than or equal to 18 y...

Vein grafts are the most used conduits in coronary artery bypass grafting (CABG), even though many studies have suggested their lower patency compared to arterial alternatives. We have reviewed the techniques and technologies that have been investigated over the years with the aim of improving the quality of these conduits. We found that preoperati...

Clinical predictors of posttransplant graft loss since the United Network for Organ Sharing (UNOS) heart allocation system change have not been well characterized. Single organ adult heart transplants from the UNOS database were identified (n = 10,252) and divided into a test cohort (n = 6,869, 67%) and validation cohort (n = 3,383, 33%). A Cox reg...

Objective Transfusions are extremely frequent after cardiac surgery, and they have a considerable economic burden and impact on outcomes. Optimal patient blood management (PBM) could play a fundamental role in reducing the rate of transfusion and Jehovah's Witnesses (JW) represent the ideal surrogate study population. This meta-analysis compares ou...

Since the time of their invention, implantable continuous flow left ventricular assist devices (LVADs) have improved the quality of life and extended survival for patients with advanced heart failure. The decision surgeons and their physician colleagues make with these patients to undergo implantation must come with full understanding of the immedi...

In June 2021, HVAD™ System distribution ceased due to observational data demonstrating increased mortality and neurological events compared to another commercial device, and a device malfunction with delay or failure to restart, especially in certain subpopulations. To assess ongoing risk for patients on support following subsequent device recalls,...

Objective: Postoperative pulmonary complications are a series of disorders that can contribute to respiratory distress and prolonged mechanical ventilation postoperatively. We hypothesise that a liberal oxygenation strategy during cardiac surgery leads to a higher incidence of postoperative pulmonary complications than a restrictive oxygenation st...

Highlights •Rapidly growing cardiac tumors can be benign or malignant. •Rarely, cardiac myxomas may grow rapidly, causing heart failure or obstructive symptoms. •Echocardiography remains the first-line imaging for cardiac tumors. •Multimodality imaging with CCT, CMR, and PET may aid in diagnosis.

Objectives: Neointimal hyperplasia and lumen irregularities are major contributors to vein graft failure and the use of VEST(R) should prevent this. In this review, we aim to evaluate the angiographic outcomes of externally supported vein grafts. Methods: Medline, Embase and Cochrane Library were systematically reviewed for randomized clinical t...

Background: Biventricular heart failure remains a clinically challenging condition to manage. Available literature describing durable biventricular (BiVAD) utilization has numerous limitations hindering the development of useful treatment algorithms. Analysis of BiVAD use within a large multicenter dataset is needed to clarify outcomes associated...

RT Cardiac Systems (RTCS, Raleigh, NC) is developing an intravascular percutaneous mechanical circulatory support (pMCS) device drive system for use during high-risk percutaneous coronary intervention and emergent cardiogenic shock. The proprietary pMCS device (US patent 10,780,206) consists of a miniaturized axial flow pump with an integrated moto...

Introduction: Although significant cardiac reverse remodeling is a prerequisite for a left ventricular (LV) assist device (LVAD) patient to be considered for device weaning, multiple factors including patient goals, physician comfort, and center experience, weigh in on this complex decision. Existing predictive models defining recovery as device re...

Introduction: Cardiac arrhythmias are common in continuous flow left ventricular assist device (LVAD) recipients. The impact of axial vs. intrapericardial centrifugal LVAD pumps on arrhythmia incidence and associated clinical outcomes is unclear. Hypothesis: This multicenter study evaluated the impact of LVAD type (axial vs. centrifugal) on inciden...

Introduction: Coumadin is currently the standard of care for long-term anticoagulation in patients supported with a left ventricular assist device (LVAD). Coumadin requires frequent testing and is associated with adverse events. The aim of this study was to evaluate the routine use of Apixaban in contemporary LVAD patients. Methods: A single center...

Aims: We analyzed the impact of the revised pediatric heart allocation policy on types of ventricular assist device (VAD) utilization, and waitlist (WL) and post-heart transplant (HT) survival outcomes in congenital heart disease (CHD) versus non-CHD patients before (Era-1) and after (Era-2) pediatric heart allocation policy implementation. Metho...

Background: Continuous flow left ventricular assist devices have improved outcomes in patients with end-stage heart failure that require mechanical circulatory support. Current devices have an adverse event profile that has hindered widespread application. The EVAHEART®2 left ventricular assist device (EVA2) has design features such as large blood...

Background Atrial and ventricular arrhythmias are commonly encountered in patients with advanced heart failure, with amiodarone being the most commonly used antiarrhythmic drug in continuous‐flow left ventricular assist device (CF‐LVAD) recipients. The purpose of this study was to assess the impact of amiodarone use on long‐term all‐cause mortality...

Inspired Therapeutics (Merritt Island, FL) is developing a mechanical circulatory support (MCS) system designed as a single driver with interchangeable, extracorporeal, magnetically levitated pumps. The NeoMate system design features an integrated centrifugal rotary pump, motor, and controller that will be housed in a single compact unit. Conceptua...

Purpose Although significant reverse cardiac remodeling is required for an LVAD-supported patient to be considered for device weaning, multiple factors including patient willingness, physician expertise, and center experience influence this complex decision. Existing predictive models defining cardiac recovery as device removal might underestimate...

Introduction Although significant cardiac structural and functional improvement is a prerequisite for an LVAD-supported patient to be considered for device weaning, multiple factors including patient willingness, physician expertise, and center experience, weigh in on this complex decision. Existing predictive models defining cardiac recovery as de...

The HeartWare HVAD System (Medtronic) is a durable implantable left ventricular assist device that has been implanted in approximately 20,000 patients worldwide for bridge to transplant and destination therapy indications. In December 2020, Medtronic issued an Urgent Medical Device Communication informing clinicians of a critical device malfunction...

This retrospective study included children aged ≤ 18 years who had durable ventricular assist devices (VAD) as a bridge to transplantation from the UNOS database between 2011 and 2020. We evaluated 90-day waitlist mortality and 1-year post-transplant mortality after VAD implantation in children stratified by race/ethnicity: Black, White, and Others...

The HeartWare HVAD System (Medtronic) is a durable implantable left ventricular assist device that has been implanted in approximately 20,000 patients worldwide for bridge to transplant and destination therapy indications. In December 2020, Medtronic issued an Urgent Medical Device Communication informing clinicians of a critical device malfunction...

The HeartWare HVAD System (Medtronic) is a durable implantable left ventricular assist device that has been implanted in approximately 20,000 patients worldwide for bridge to transplant and destination therapy indications. In December 2020, Medtronic issued an Urgent Medical Device Communication informing clinicians of a critical device malfunction...

Background The objective of this study was to evaluate annual heart transplant volumes and 3-year post-transplant outcomes since establishment of United Network for Organ Sharing (UNOS) database stratified by race. Methods The UNOS thoracic transplant database was evaluated for adult patients since 1987. The available database was then stratified...

PurposePediatric heart failure patients remain in critical need of a dedicated mechanical circulatory support (MCS) solution as development efforts for specific pediatric devices continue to fall behind those for the adult population. The Inspired Pediatric VAD is being developed as a pediatric specific MCS solution to provide up to 30-days of circ...

Patients with left ventricular assist devices currently require long-term anticoagulation with warfarin. Warfarin requires frequent blood tests and is associated with adverse events when not in the therapeutic range. Apixaban is a possible alternative that is potentially better for compliance and requires no additional testing. The purpose of this...

ACCEPTED to the ISHLT 42nd Annual Meeting and Scientific Sessions to be held in-person 27-30 April 2022 at the John B. Hynes Convention Center in Boston, MA, USA

Objectives: This study aimed to compare the clinical characteristics, risk factors, and overall survival outcomes in adults with congenital heart disease (ACHD) bridged to transplantation with ventricular assist device (VAD) vs. no-VAD. Methods: The study included 894 ACHD patients aged ≥ 18 years listed for primary heart transplantation between 20...

Purpose: Despite the availability of first-generation extracorporeal mechanical circulatory support (MCS) systems that are widely used throughout the world, there is a need for the next generation of smaller, more portable devices (designed without cables and a minimal number of connectors) that can be used in all in-hospital and transport setting...

The study aim was to examine the impact time in therapeutic range (TTR, International Normalized Ratio [INR] 2.0-3.0) has on survival and adverse events in patients receiving the HeartWare HVAD System in the ENDURANCE and ENDURANCE Supplemental Trials. Evaluable subjects (n = 495) had >1 INR value recorded 1-24 months postimplant and were categoriz...

Background Stentless porcine bioprothesis is a surgical strategy to treat aortic root disease. Use has been limited due to the concern for long-term valve degeneration. This study evaluated the perioperative and late outcomes of patients with aortic root disease requiring root replacement. Methods A total of 409 patients underwent aortic root repl...

Logfiles from the HeartWare HVAD System provide operational pump trend data to aid in patient management. Pump thrombosis is commonly associated with increases in the logfile power that may precede the clinical presentation. A Power Tracking algorithm was developed to detect significant deviations in pump power that may be associated with pump thro...

In the US, the most significant morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) is embolic stroke, with 90% of thrombus originating from the left atrial appendage (LAA). Anticoagulation is the preferred treatment for the prevention of stroke in NVAF patients, but clinical studies have demonstrated high levels of non-...

Aims Continuous-flow left ventricular assist devices (LVADs) as destination therapy (DT) are a recommended treatment by National Institute for Health and Care Excellence England for end-stage heart failure patients ineligible for cardiac transplantation. Despite the fact that DT is frequently used as an LVAD indication across other major European c...

Left ventricular assist devices (LVADs) improve quality of life (QoL) and functional capacity (FC) for patients with advanced heart failure. The association between adverse events (AEs) and changes in QoL and FC are unknown. Patients treated with the HeartWare ventricular assist device (HVAD) with paired 6-minute walk distance (6MWD, n = 263) and K...

Background: Use of continuous flow left ventricular assist devices (CFVAD) has previously increased over the years as bridge to transplant (BTT). The Heartware HVAD and HeartMate III (HM3) are currently approved centrifugal flow devices used for BTT. We sought to evaluate outcomes of the patients listed and transplanted after receiving these two d...

The objective of the study is to compare the clinical characteristics, risk factors, and overall survival (waitlist and post-transplant) outcomes in children with congenital heart disease (CHD) bridged to transplantation with either a VAD vs. ECMO vs. no mechanical circulatory support (MCS) in the recent era. The study included 2899 primary heart t...

Orthotropic heart transplantation remains the most effective therapy for patients with end-stage heart failure, with a median survival of ≈13 years. Yet, a number of complications are observed after orthotropic heart transplantation, including atrial and ventricular arrhythmias. Several factors contribute to arrhythmias, such as autonomic denervati...

Presentation Number 1041-11

Background: Implantable cardioverter defibrillators (ICD) have been shown to have survival advantage in advanced heart failure patients. Few studies have evaluated the role of ICDs in patients supported with continuous flow left ventricular assist devices (CFVAD). Objective: We aimed to evaluate the impact of ICD and CFVAD on heart transplant (H...

Accepted for oral presentation to the ISHLT 41st Annual Meeting and Scientific Sessions to be held 27-30 April, 2021

Purpose Neutrophil to Lymphocyte Ratio (NLR) can predict mortality/complications in LVAD patients; however, the prognostic value of longitudinal NLR measurements has not been well studied. Here we examine the mortality/complication incidence in patients with chronically increased NLR verses patients with acutely elevated NLR as a predictor of patie...

Pediatric heart failure (HF) patients have been a historically underserved population for mechanical circulatory support (MCS) therapy. To address this clinical need, we are developing a low cost, universal magnetically levitated extracorporeal system with interchangeable pump heads for pediatric support. Two impeller and pump designs (pump V1 and...

Background Left ventricular assist device (LVAD) unloading and hemodynamic support in patients with advanced chronic heart failure can result in significant improvement in cardiac function allowing LVAD removal; however, the rate of this is generally considered to be low. This prospective multicenter nonrandomized study (RESTAGE-HF [Remission from...

Objectives To compare the performance of a novel NeurOs cerebral oximetry monitor against the INVOS monitor during the entire intraoperative phase of cardiac surgery, including periods of known fluctuation in brain oxygenation, such as preoxygenation, induction, cannulation, and cardiopulmonary bypass. Design This study was a prospective, nonrando...

Background ABO incompatible (ABOi) heart transplantation (HT) in infants has been utilized to reduce waitlist time and mortality with comparable outcomes to ABO compatible (ABOc). We sought to assess trends in ABOi listing and transplantation for infants within the United Network for Organ Sharing (UNOS) registry and to evaluate its influence on ou...

Rotary blood pumps have demonstrated superior device safety and performance compared with first-generation volume displacement pumps. The first generation of axial and centrifugal flow devices operate at constant speeds (rpm) delivering continuous end-organ blood flow, but with diminished vascular pulsatility and non-phasic volume unloading. It has...

There is limited data on the cost-effectiveness of continuous-flow left ventricular assist devices (LVAD) in the United States particularly for the bridge-to-transplant indication. Our objective is to study the cost-effectiveness of a small intrapericardial centrifugal LVAD compared with medical management (MM) and subsequent heart transplantation...

Background. We hypothesize that preoperative functional platelet number (platelet count multiplied by platelet aggregation percentage) are associated with 30-day mortality after cardiac surgery. Methods. We linked our preoperative testing database with the STS (Society of Thoracic Surgeon) database to form a study cohort of 1390 patients who had ca...

This study reports the first analysis regarding cost-effectiveness of left ventricular assist device (LVAD) implantation via thoracotomy. Cost-effectiveness of LVADs implanted via the traditional surgical approach of sternotomy has been improved through the years because of technological advances, along with understanding the importance of patient...

Background: Often, only saphenous vein grafts (SVGs) are used in emergent coronary artery bypass graft (CABG) procedures to provide quicker myocardial revascularization despite its lower long-term patency relative to the internal mammary artery (IMA) grafts. We examined differences between IMA and non-IMA graft recipients in emergent CABGs and its...

Durable and temporary mechanical circulatory support (MCS) device support provides life-saving benefit for patients with advanced heart failure but is associated with major adverse events. The accurate categorization and documentation of adverse events associated with MCS device therapy has long been recognized as an essential requirement to adequa...

Objectives In patients with reduced kidney function there are no established guidelines to suggest combined heart-kidney transplant (HKTx) versus sequential kidney transplant (SKTx) using preoperative value of estimated glomerular filtration (eGFR). Methods The United Network for Organ Sharing database was queried from 2000 to 2015 to evaluate sur...

Cardiac resynchronization therapy (CRT) improves outcomes in heart failure patients with wide QRS complex. However, CRT management following continuous flow Left Ventricular Assist Device (LVAD) implant vary: some centers continue CRT while others turn off the left ventricular (LV) lead at LVAD implant. We sought to study the effect of continued CR...