Eleni P. Asimacopoulos^*, Steven J. Staffa, Peter C. Laussen, Kirsten C. Odegard

Congenital Heart Disease, Vol.17, No.5, pp. 579-590, 2022, DOI:10.32604/chd.2022.020334 - 06 September 2022

Abstract Background: Thromboembolic events are a cause of significant morbidity and mortality in the Fontan population. We previously reported on coagulation profile changes in a cohort of patients with hypoplastic left heart syndrome (HLHS) from Stage I through Fontan completion. In this report, we examine their clinical status, anticoagulation and incidence of thromboembolic events up to 20 years post Fontan. Methods: A retrospective chart review was conducted for twenty (20) surviving patients, from 1998 through December 2020. Patients who underwent orthotopic heart transplantation (OTx) were followed until their transplant. Patients who were found in the original study… More >

Clarissa M. Gurbani¹, Vincent Khor², Jeffrey J. Leow¹, Melissa H.W. Tay³, Yew-Lam Chong¹

Canadian Journal of Urology, Vol.27, No.3, pp. 10270-10272, 2020

Abstract Wunderlich syndrome (WS) is a rare triad of flank pain, flank mass and hypovolemic shock and is classically attributed to angiomyolipomata or neoplasms. Treatment is guided by clinical severity: conservative, selective arterial embolization, or nephrectomy. We report an atypical case of a 69-year old man with a pre-existing 9 cm left renal tumor who developed WS secondary to anticoagulation and simple cyst rupture from his contralateral kidney, complicated by abdominal compartment syndrome with hemodynamic instability despite inotropic support and robust resuscitation. Early recognition and source control via radical nephrectomy were essential in securing a positive More >

Lydia Glick¹, Thenappan Chandrasekar¹, Scott G. Hubosky¹, Seth Teplitsky², Mihir Shah³, Joon Yau Leong¹, Geoffrey Ouma⁴, James R. Mark¹

Canadian Journal of Urology, Vol.27, No.6, pp. 10480-10487, 2020

Abstract Appropriate perioperative management of antithrombotic medications is critical; for every patient, the risk of bleeding must be balanced against individual risk of thrombosis. There has been a rapid influx of new antithrombotic therapies in the past 5 years, yet there is a lack of clear and concise guidelines on the management of anticoagulant and antiplatelet therapy during urologic surgery. Here we describe our approach to perioperative antithrombotic counseling, including the timing of stopping and restarting these medications. These practice guidelines have been developed in consultation with the Vascular Medicine service at our institution as well More >

Qi Dang¹, Chun-Gong Li¹, Xin-Xin Jin¹, Ya-Jin Zhao¹, Xiang Wang^1,*

Molecular & Cellular Biomechanics, Vol.16, Suppl.2, pp. 146-146, 2019, DOI:10.32604/mcb.2019.07074

Abstract Endotoxin is a a very powerful and toxic inflammatory stimulator usually leading to the sepsis occurred. In order to remove endotoxin better through hemoperfusion, it is a pretty choice to increase the length of molecular linker on adsorbents. In this study, we chose the heparin as a molecular linker because of its being anticoagulant linear polysaccharide. Heparin as a linker was covalently immobilized on the chloromethylated polystyrene microspheres (Ps) and then connected with L-phenylalanine (Phe) forming the Ps-Hep-Phe structure to adsorbed endotoxin better. The property of microspheres was characterized by Fourier transform infrared spectroscopy, X-ray More >

Ketina Arslani^1*, Lukas Notz^1*, Marzena Zurek¹, Matthias Greutmann², Markus Schwerzmann³, Judith Bouchardy⁴, Reto Engel⁵, Christine Attenhofer Jost⁶, Daniel Tobler¹

Congenital Heart Disease, Vol.13, No.5, pp. 678-684, 2018, DOI:10.1111/chd.12627

Abstract Background: In adults with congenital heart disease (CHD) and atrial arrhythmias, recommendations for thromboprophylaxis are vague and evidence is lacking. We aimed to identify factors that influence decision-making in daily practice.
Methods: From the Swiss Adult Congenital HEart disease Registry (SACHER) we identified 241 patients with either atrial fibrillation (Afib) or atrial flutter/intraatrial reentrant tachycardia (Aflut/ IART). The mode of anticoagulation was reviewed. Logistic regression models were used to assess factors that were associated with oral anticoagulation therapy.
Results: Compared with patients with Aflut/IART, patients with Afib were older (51 ± 16.1 vs 37 ± 16 years, P… More >

Karen Hinsley, Margaret Evans-Langhorst, Courtney Porter, Stephanie Chandler, Christina VanderPluym, John Triedman, Vassilios J. Bezzerides

Congenital Heart Disease, Vol.13, No.2, pp. 222-225, 2018, DOI:10.1111/chd.12551

Abstract Objective: This quality improvement study was implemented to demonstrate consistent and reliable post procedure anticoagulation for patients undergoing left-sided ablations. We evaluated the safety and efficacy of anticoagulation practice during a transition from anticoagulation with overnight infusion of unfractionated heparin to a single subcutaneous injection of low molecular weight heparin.
Methods: Outcomes for patients who received unfractionated heparin from January 2014 to October 2014, were compared with outcomes of patients who received low molecular weight heparin from October 2014 to October 2015. Complications prepractice and postpractice change were documented and compared to establish confidence in the practice… More >

Uri Pollak^1,2,3, David Mishaly^3,4, Gili Kenet^3,5, Amir Vardi^1,3

Congenital Heart Disease, Vol.13, No.1, pp. 16-25, 2018, DOI:10.1111/chd.12557

Abstract Heparin-induced thrombocytopenia (HIT) is a life-threatening complication of heparin therapy. The risk for HIT correlates with the cumulative dosage of heparin exposure. In Fontan patients, recurrent systemic anticoagulation, traditionally with heparin, is used to alleviate the thrombotic complications that may occur postoperatively when the venous pressure rises and the systemic venous flow into the pulmonary arteries becomes sluggish, putting them at increased risk. As a pressure gradient-dependent circulation, elevation in systemic venous pressure, most often by venous thrombosis, contributes to circuit failure. Therefore, when HIT complicates patients after the Fontan procedure, it is associated with More >

Ying Mao¹, Chaojing Li¹, Peng Ge¹, Fujun Wang^1,*, Lu Wang^1,*

Molecular & Cellular Biomechanics, Vol.15, No.3, pp. 143-154, 2018, DOI:10.3970/mcb.2018.03987

Abstract Heparin/ PEG-PCL core-shell microcarriers were fabricated in one-step via coaxial-electrospraying technology. Optimization of the coaxial-electrospraying processing is by controlling the PEG-PCL concentration, applied voltage, receiving distance, and feed rate. The influence of the electrospray parameters on microsphere morphology was studied by optical microscopy and scanning electron microscopy. The functional groups and components of the electrosprayed microspheres were characterized by Fourier transform infrared spectroscopy (FTIR). Transmission electron microscope (TEM) observation proved the core-shell structure of heparin-loaded PEG-PCL microspheres. Drug loading and releasing study demonstrated that PEG-PCL concentration could control the encapsulation efficiency and releasing activity of More >

Jane W. Newburger

Congenital Heart Disease, Vol.12, No.5, pp. 641-643, 2017, DOI:10.1111/chd.12502

Abstract Medical therapies in patients with Kawasaki disease (KD) are administered to reduce the prevalence of coronary aneurysms, reduce systemic inflammation, and prevent coronary thrombosis. All patients with acute KD should be treated with intravenous immunoglobulin (IVIG) 2 g/kg, generally administered over 10–12 hours. Aspirin has never been shown to prevent aneurysms, but is given for its anti-inflammatory and antipyretic effects until the patient has been afebrile for 2 days, then lowered to an antiplatelet dose. Adjunctive therapy with a longer course of corticosteroids, together with IVIG and aspirin, may be considered for primary treatment in More >

Nicolas B. Delongchamps¹, Grégoire Robert², Alexandre de la Taille³, Olivier Haillot⁴, Charles Ballereau⁵, Christian Saussine⁶, François Kleinclauss⁷, Abdel-Rahmène Azzouzi⁸, Bertrand Lukacs⁹, Olivier Dumonceau¹⁰, Marc Fourmarier¹¹, Marian Devonec¹², Aurélien Descazeaud¹³

Canadian Journal of Urology, Vol.18, No.6, pp. 6007-6012, 2011

Abstract Introduction: To compare postoperative outcomes of patients on oral anticoagulation (OA) treated with transurethral plasma vaporization of the prostate in saline water (TUVis) and transurethral resection of the prostate (TURP).
Materials and methods: Between January and December 2009, 111 patients on OA therapy were treated with either TURP or TUVis in eight centers. Types of OA and perioperative management were collected. Postoperative outcomes were statistically compared between the two groups.
Results: A total of 57 (51%) and 54 (49%) patients were treated with TURP and TUVis, respectively. Types of OA were not significantly different between the two groups,… More >