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Featured researches published by B. Cagliostro.


Journal of Heart and Lung Transplantation | 2016

Continuous-flow left ventricular assist devices and usefulness of a standardized strategy to reduce drive-line infections

B. Cagliostro; A.P. Levin; Justin Fried; Scott Stewart; Grant Parkis; K.P. Mody; A.R. Garan; V.K. Topkara; Hiroo Takayama; Yoshifumi Naka; Ulrich P. Jorde; Nir Uriel

BACKGROUND Drive-line infection (DLI) is a common complication of left ventricular assist device (LVAD) support, leading to significant morbidity that jeopardizes the benefits of these devices. It has been reported that DLI incidence is related to drive-line dressing strategies. The aim of this study was to determine whether implementation of a standardized drive-line care kit would reduce the incidence of DLIs. METHODS DLI data were collected prospectively on all LVAD patients implanted between 2009 and 2013 at Columbia University Medical Center. Drive-line care was altered on June 1, 2011, from a dry sterile dressing without a standard anchoring device to a standardized kit, which included silver gauze dressing and a standard anchoring device. The silver dressing was used until the wound incorporated, with a minimum of 1 month. RESULTS During the study period, 107 patients were implanted with LVADs before implementation of a standardized kit (Group A) and 159 thereafter (Group B). Median follow-up time (censoring at June 2011) for Group A was 8.73 (IQR 3.51 to 17.47) months and 11.65 (IQR 6.66 to 35.20) months for Group B (p = 0.17). DLI event rate improved from 0.18 to 0.07 event per patient-year, corresponding to a relative risk reduction of 62.5%. In addition, the 1-year freedom from infection was significantly increased in Group B (92.46%) compared with Group A (81.94%) (log rank = 0.036). CONCLUSION The use of a standardized kit, including silver dressing and a standard anchoring device, leads to decrease in DLI with an absolute risk reduction of 11%. Routine use of these dressing techniques is warranted based on our findings, and may lead to reduction of complications related to infections.


Journal of Heart and Lung Transplantation | 2017

An ISHLT consensus document for prevention and management strategies for mechanical circulatory support infection

Shimon Kusne; Martha L. Mooney; Lara Danziger-Isakov; A. Kaan; Lars H. Lund; Haifa Lyster; Georg Wieselthaler; Saima Aslam; B. Cagliostro; Jonathan M. Chen; Pamela Combs; A.B. Cochrane; Jennifer Conway; Jennifer Cowger; Maria Frigerio; Rochelle Gellatly; Paolo Grossi; Finn Gustafsson; Margaret M. Hannan; Angela Lorts; Stanley I. Martin; Sean Pinney; Fernanda P. Silveira; Stephan Schubert; Stephan Schueler; M. Strueber; Nir Uriel; Neil Wrightson; Rachel Zabner; Shirish Huprikar

1053-2498/


European heart journal. Acute cardiovascular care | 2016

Advanced cardiovascular life support algorithm for the management of the hospitalized unresponsive patient on continuous flow left ventricular assist device support outside the intensive care unit

M. Yuzefpolskaya; Nir Uriel; Margaret Flannery; Natalie Yip; K.P. Mody; B. Cagliostro; Hiroo Takayama; Yoshifumi Naka; Ulrich P. Jorde; Sumeet Goswami; P.C. Colombo

see fron rights reserved. http://dx.doi.org/10.10 Authors’ Disclosure The authors have m Heart and Lung Transp S.A., P.G., M.H., S.M Pediatric Thoracic T Schubert) Nursing, Health Sci Heart Failure and T F.G., A.L., S.P., S.Sch Pharmacy and Phar Mechanical Circulat F.G., A.L., S.P., S.S., The following auth Circulatory Assist Clin Reprint requests: S Arizona, 5777 East M +480 342 0115. Fax: E-mail address: ku CONSENSUS STATEMENT


Asaio Journal | 2016

Effect of CYP2C9 and VKORC1 Gene Variants on Warfarin Response in Patients with Continuous-Flow Left Ventricular Assist Devices.

V.K. Topkara; Robert J. Knotts; Douglas L. Jennings; A.R. Garan; A.P. Levin; Alexander Breskin; F. Castagna; B. Cagliostro; M. Yuzefpolskaya; Koji Takeda; Hiroo Takayama; Nir Uriel; Donna Mancini; Andrew Eisenberger; Yoshifumi Naka; P.C. Colombo; Ulrich P. Jorde

Over the past decade, continuous flow left ventricular assist devices (CF-LVADs) have become the mainstay of therapy for end stage heart failure. While the number of patients on support is exponentially growing, at present there are no American Heart Association or European Society of Cardiology Advanced Cardiovascular Life Support guidelines for the management of this unique patient population. We propose an algorithm for the hospitalized unresponsive CF-LVAD patient outside of the intensive care unit setting. Key elements of this algorithm are: creation of a dedicated LVAD code pager and LVAD code team; early assessment and correction of LVAD malfunction; early determination of blood flow using Doppler technique in carotid and femoral arteries; prompt administration of external chest compressions in the absence of Doppler flow; bedside veno-arterial extracorporeal membranous oxygenation support if no response to resuscitation measures; and early consideration for stroke.


Journal of Heart and Lung Transplantation | 2018

A Prospective Validation of the First Endoscopic Management Algorithm for Gastrointestinal Bleeding in Patients with Continuous-Flow Left Ventricular Assist Devices

Jordan E. Axelrad; A. Pinsino; Anusorn Thanataveerat; B. Cagliostro; Margaret Flannery; K. Ross; R. Te-Frey; L. Effner; A.R. Garan; V.K. Topkara; Hiroo Takayama; Koji Takeda; Y. Naka; P.C. Colombo; Tamas A. Gonda; M. Yuzefpolskaya

Bleeding and thrombotic complications continue to plague continuous-flow left ventricular assist device (CF-LVAD) therapy in patients with end-stage heart failure. Warfarin genotyping information can be incorporated into decision making for initial dosing as recommended by the Food and Drug Administration; however, clinical utility of this data in the CF-LVAD population has not been well studied. Genotypes testing for CYP2C9 and VCORC1 polymorphisms were determined in 90 CF-LVAD patients. Outcomes studied were the association of CYP2C9 (*1, *2, or *3) and VKORC1 (-1639 G>A) gene variants with time-to-target international normalized ratio (INR), total warfarin dose, maintenance warfarin dose. Continuous-flow left ventricular assist device patients carrying a rare variant in the VKORC1 gene had a significantly lower cumulative warfarin dose until target INR achieved (18.9 vs. 35.0 mg, p = 0.002), days spent until INR target achieved (4.9 vs. 7.0 days, p = 0.021), and discharge warfarin dose (3.2 vs. 5.6 mg, p = 0.001) compared with patients with wild-type genotype. Genotype-guided warfarin dosing may lead to safer anticoagulation and potentially improve outcomes in CF-LVAD patients.


Journal of Heart and Lung Transplantation | 2018

Predictive Value of Mean Arterial Pressure Versus Systolic Blood Pressure and Visit-To-Visit Blood Pressure Variability for Stroke and Pump Thrombosis in HeartMate II Patients

A. Pinsino; F. Castagna; Joshua Z. Willey; A.M. Zuver; Margaret Flannery; B. Cagliostro; J.R. Cockroft; A.R. Garan; V.K. Topkara; Hiroo Takayama; Koji Takeda; Y. Naka; Ryan T. Demmer; P.C. Colombo; M. Yuzefpolskaya


Journal of Heart and Lung Transplantation | 2016

Genotype-Guided Warfarin Dosing in Continuous-Flow Left-Ventricular Assist Device (CF-LVAD) Patients

Douglas L. Jennings; Randall C. Li; A.R. Garan; M. Yuzefpolskaya; Koji Takeda; Hiroo Takayama; B. Cagliostro; Margaret Flannery; B. Toennes; Maryjane Farr; Donna Mancini; Y. Naka; P.C. Colombo; V.K. Topkara


Circulation-heart Failure | 2016

Myocardial Recovery in Patients Receiving Contemporary Left Ventricular Assist Devices

V.K. Topkara; A. Reshad Garan; Barry Fine; Amandine Godier-Furnemont; Alexander Breskin; B. Cagliostro; M. Yuzefpolskaya; Koji Takeda; Hiroo Takayama; Donna Mancini; Yoshifumi Naka; P.C. Colombo


Journal of Heart and Lung Transplantation | 2015

Use of Phosphodiesterase 5 Inhibitors in Continuous-Flow Left Ventricular Assist Device Patients With Pulmonary: Hypertension: A Contemporary Analysis

V.K. Topkara; A. Godier-Furnemont; A. Levin; A.R. Garan; B. Cagliostro; R. Te-Frey; F. Torres; Koji Takeda; Hiroo Takayama; M. Yuzefpolskaya; Ulrich P. Jorde; Donna Mancini; Yoshifumi Naka; P.C. Colombo


Journal of Heart and Lung Transplantation | 2015

VKORC1 Genotype Predicts Warfarin Dosing and INR Kinetics in Patients With Continuous-Flow Left Ventricular Assist Devices (CF-LVADs)

V.K. Topkara; A. Levin; K.P. Mody; A.R. Garan; B. Cagliostro; Margaret Flannery; R. Te-Frey; F. Torres; Koji Takeda; Hiroo Takayama; M. Yuzefpolskaya; Donna Mancini; Yoshifumi Naka; P.C. Colombo; Ulrich P. Jorde

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Hiroo Takayama

Columbia University Medical Center

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M. Yuzefpolskaya

Columbia University Medical Center

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P.C. Colombo

Columbia University Medical Center

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V.K. Topkara

Columbia University Medical Center

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Donna Mancini

Icahn School of Medicine at Mount Sinai

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Koji Takeda

Columbia University Medical Center

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Margaret Flannery

Columbia University Medical Center

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Ulrich P. Jorde

Albert Einstein College of Medicine

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Nir Uriel

University of Chicago

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