				search

Current Research & Innovations

Cardiac

Atherosclerosis: Studying Predictors of Right Ventricular Function (Multi-Ethnic Study) —This multi-ethnic study of atherosclerosis focuses on endothelial dysfunction and the right ventricle. (Steven Kawut, MD, MS)
Biventricular Pacing after Cardiac Surgery BiPACS Trial — (Henry Spotnitz, MD)
Biventricular Pacing After Cardiopulmonary Bypass —The purpose of this study is to investigate the efficacy of optimized temporary biventricular pacing in patients undergoing open-heart surgery with preoperative left ventricular dysfunction and an intraventricular conduction delay. This study will compare extended temporary biventricular pacing versus no pacing by assessing patients randomized to the two groups over three time points using different measures of cardiac output. Results from this research will demonstrate whether temporary biventricular pacing improves cardiac output after open-heart surgery and whether ventricular pacing site, right-left ventricular delay, and atrioventricular delay optimization increase cardiac output in this setting. Success would lead to the development of recommendations for use of biventricular pacing post-operatively, and would stimulate the development of pacemakers with appropriate features. (Henry Spotnitz, MD)
Biventricular Pacing After Off-Pump Cardiac Surgery —The purpose of this study is to investigate the efficacy of optimized temporary biventricular pacing in patients undergoing off-pump cardiac surgery with preoperative left ventricular dysfunction and an intraventricular conduction delay. This study will compare optimized temporary biventricular pacing versus no pacing by assessing cardiac output in these states. Results from this research will demonstrate whether temporary biventricular pacing improves cardiac output after off-pump cardiac surgery and whether ventricular pacing site, right-left ventricular delay, and atrioventricular delay optimization increase cardiac output in this setting. Success would lead to the development of recommendations for use of biventricular pacing post-operatively, and would stimulate the development of pacemakers with appropriate features. (Henry Spotnitz, MD)
Biventricular Pacing After Off-Pump Cardiac Surgery (BiPOP) —The purpose of this study is to investigate the efficacy of optimized temporary biventricular pacing in patients undergoing off-pump cardiac surgery with preoperative left ventricular dysfunction and an intraventricular conduction delay. This study will compare optimized temporary biventricular pacing versus no pacing by assessing cardiac output in these states. Results from this research will demonstrate whether temporary biventricular pacing improves cardiac output after off-pump cardiac surgery and whether ventricular pacing site, right-left ventricular delay, and atrioventricular delay optimization increase cardiac output in this setting. Success would lead to the development of recommendations for use of biventricular pacing post-operatively, and would stimulate the development of pacemakers with appropriate features. (Henry Spotnitz, MD)
Comparison of Neurohormonal Responses to Pulsatile vs. Mechanical Circulatory Support —This study will use a combination of gene array and serum ELISA techniques in an effort to identify pathways and effector molecules involved in this response. (Yoshifumi Naka, MD, PhD)
Effect of Left Ventricle Lead Location in Biventricuar Pacing —The objective of this research is to determine the efficacy of left ventricular lead placement during biventricular pacing in patients with coronary artery disease and a wall motion abnormality, and to optimize the effects of this method on changes in cardiac output, stroke volume, and regional wall motion. Results from this study will demonstrate whether specific lead locations combined with optimized biventricular pacing improves cardiac output in this setting. Success would lead to more prolonged studies in the postoperative period. (Henry Spotnitz, MD)
Epidemiology of Bleeding — (Naka Yoshifumi, MD, PhD)
Evaluation of Interventions for Moderate Ischemic Mitral Valve Regurgitation —The objective of this study is to evaluate the safety and efficacy of mitral valve repair for moderate ischemic mitral regurgitation. The study compares mitral valve repair combined with coronary artery bypass grafting to coronary artery bypass grafting alone in this patient population. (Eric Rose, MD)
Evaluation of Outcomes Following Mitral Valve Repair/Replacement in Severe Chronic Ischemic Mitral Regurgitation —The objective of this study is to evaluate the safety and efficacy of mitral valve repair and mitral valve replacement for patients with severe ischemic mitral regurgitation (MR). The study compares mitral valve repair with annuloplasty and a subvalvular procedure for severe tethering to outcomes of mitral valve replacement and complete preservation of the sub-valvular apparatus in this patient population. (Eric Rose, MD)
LVAD Research —SCCOR Grant Supports Extensive LVAD Research. LVAD Research (Eric Rose, MD)
Minimally Invasive Versus Standard — (Michael Argenziano, )
Molecular and Genetic Analysis of Aortic Aneurysms —The specific aims of this study are: 1. To characterize gene expression differences between normal and aneurysmal aortas; 2. To correlate clinical behavior of aneurysms with differential gene expression in a range of diseased aortas; 3. To evaluate the products of differentially expressed genes as serum markers for an increased risk of complications. (Allan Stewart, MD)
Multisite Ventricular Pacing After the Fontan Procedure —Ventricular dysfunction occurs in up to 25% of patients after cardiac surgery with cardiopulmonary bypass (CPB) for repair or palliation of congenital heart disease. Ventricular dysfunction has been linked to patient morbidity after Fontan palliation of “single ventricle”. Multi-site Ventricular Pacing (MSVP) benefit patients with chronic heart failure by increasing stroke volume and cardiac output (CO). The improvement results from reversal of ventricular dyssynchrony, which increases the efficiency of pump function. Similar benefits have been demonstrated in acute ventricular dysfunction after CPB for repair of acquired heart disease. Our study aims to determine the efficacy of MSVP after Fontan palliation for “single ventricle” congenital heart disease. MSVP after the Fontan operation will utilize two pacing leads on the single ventricle, and will optimize Atrioventricular Delay (AVD) and Interventricular Delay (IVD) , which in this case is the timing between two leads on the same ventricle. Our hypothesis is that optimized MSVP will increase CO by 10% with no increase in inotropes, afterload reduction, or volume infusion. Each patient will serve as his/her own control. These results will provide preliminary data for clinical trials utilizing MSVP to improve care of patients after Fontan palliation, both in the ICU during recovery and long-term. (Henry Spotnitz, MD)
Optimized Biventricular Pacing in Allograft Recipients or Biventricular Pacing Before Transplant (BiBeT) —The purpose of this study is to investigate the mechanics and methods of optimized Biventricular Pacing (BiVP) in patients with NYHA Class III or IV heart failure. This study will examine the ability to optimize BiVP for both Right Left Delay and LV-site in order to maximize CO as compared to traditional atrial (AAI) pacing. Results from this study will also demonstrate the usefulness of optimizing BiVP site-timing to maximize CO as compared with AAI pacing. Patients with heart failure, LV ejection fraction <36% and QRS duration >119 msec will be studied in the operating room just prior to cardiac transplantation. A temporary biventricular pacemaker will be used to pace the failing heart with a random array of BiVP variables of LV site and RLD. Cardiac output will be measured directly with an aortic flowmeter. The LV site-RLD combination resulting in the highest cardiac output will then be compared to conventional atrial pacing. Secondary analysis of QRS duration will also lead to testing of the LV site-RLD combination that results in the shortest QRS duration to be compared to atrial pacing as well. (Henry Spotnitz, MD)
PACTS CR Project — (Michael Argenziano, MD)
Paired Cardiac Tissue from LVAD — (Yoshifumi Naka, MD, PhD)
Phase II Clinical Study of the Safety and Performance of the Relay Thoracic Stent Graft in Patients with Thoracic Aortic Pathologies — (Allan Stewart, MD)
Predicting RV Failure Among LV — (Yoshifumi Naka, )
Recover I — (Yoshifumi Naka, MD, PhD)
Retrospective Review After Surgery for Afibrillation — (Michael Argenziano, MD)
SCCOR —NIH grant to improving outcomes for end-stage heart failure patients with implanted mechanical devices. SCCOR (Eric Rose, MD and Alan J. Moskowitz, MD)
Trifecta Valve —An observational, prospective evaluation of the Trifecta valve. (Allan Stewart, MD)
Ventrassist LVAD Bridge to Transplant — (Yoshifumi Naka, MD, PhD)
Ventrassist LVAD Bridge to Transplant, Feasibility Phase —The purpose of this clinical study is to evaluate the VentrAssist™ LVAS as a treatment for End Stage Heart Failure subjects who require circulatory assistance while awaiting a heart transplant. (Yoshifumi Naka, MD, PhD)
Ventricular Function During Neonatal Cardiac Surgery —The purppose of this study is to examine the effect of surgical palliation of neonatal functional single ventricle on heart function. Improved pump function during corrective surgery will be correlated with changes in myocardial properties, since impaired contractility and compliance can be hidden by improved hemodynamics. Specifically, we will: 1.) Examine the effect of acute ventricular volume overload, as well as its reversal, on systolic and diastolic indices of ventricular function. 2.) Evaluate the acute effects of increased afterload immediately after surgical palliation on ventricular function. This will be achieved by the use of quantitative two-dimensional echocardiography (pre-, intra-, and postoperatively at 2 weeks, 2 months, and 6 months), one intraventricular pressure tip catheter, and an electromagnetic peri-aortic flow probe (intraoperatively). Conventional monitoring techniques may not identify patients at risk for poor ventricular function postoperatively. Intraoperative data will also be correlated with demographic data, postoperative course and follow up echocardiographic studies. This study will help improve care of neonates undergoing cardiac surgery and better define the pathophysiology of single ventricular forms of congenital heart disease. (Henry Spotnitz, MD)