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31 results on '"MONREAL, GRETEL"'

16. Hemodynamic Changes and Retrograde Flow in LVAD Failure

Author

Giridharan, Guruprasad A., primary, Koenig, Steven C., additional, Soucy, Kevin G., additional, Choi, Young, additional, Pirbodaghi, Tohid, additional, Bartoli, Carlo R., additional, Monreal, Gretel, additional, Sobieski, Michael A., additional, Schumer, Erin, additional, Cheng, Allen, additional, and Slaughter, Mark S., additional

Published
2015
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18. Feasibility Study of Particulate Extracellular Matrix (P-ECM) and Left Ventricular Assist Device (HVAD) Therapy in Chronic Ischemic Heart Failure Bovine Model

Author

Soucy, Kevin G., primary, Smith, Erin F., additional, Monreal, Gretel, additional, Rokosh, Gregg, additional, Keller, Brad B., additional, Yuan, Fangping, additional, Matheny, Robert G., additional, Fallon, Anna M., additional, Lewis, Beecher C., additional, Sherwood, Leslie C., additional, Sobieski, Michael A., additional, Giridharan, Guruprasad A., additional, Koenig, Steven C., additional, and Slaughter, Mark S., additional

Published
2015
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22. Left ventricular assist devices: current controversies and future directions.

Author

Schumer, Erin M., Black, Matthew C., Monreal, Gretel, and Slaughte, Mark S.

Abstract

Advanced heart failure is a growing epidemic that leads to significant suffering and economic losses. The development of left ventricular assist devices (LVADs) has led to improved quality of life and long-term survival for patients diagnosed with this devastating condition. This review briefly summarizes the short history and clinical outcomes of Lads and focuses on the current controversies and issues facing LVAD therapy. Finally, the future directions for the role of LVADs in the treatment of end-stage heart failure are discussed. [ABSTRACT FROM AUTHOR]

Published
2016
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23. Early Feasibility Testing and Engineering Development of the Transapical Approach for the HeartWare MVAD Ventricular Assist System

Author

Tamez, Daniel, primary, LaRose, Jeffrey A., additional, Shambaugh, Charles, additional, Chorpenning, Katherine, additional, Soucy, Kevin G., additional, Sobieski, Michael A., additional, Sherwood, Leslie, additional, Giridharan, Guruprasad A., additional, Monreal, Gretel, additional, Koenig, Steven C., additional, and Slaughter, Mark S., additional

Published
2014
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29. Ventricular Remodeling in a Large Animal Model of Heart Failure

Author

Monreal, Gretel

Subjects
Biomedical Research, heart failure, cardiac assist device, cytoskeleton, electrolytes, desmin, remodeling
Abstract

Ventricular remodeling in chronic heart failure (CHF) often occurs following myocardial infarction (MI), yet the natural history remains unpredictable due to the chronicity of the process and therapeutic interventions involved. Ventricular remodeling is a dynamic process encompassing anatomical changes (ventricular dilation, cardiomegaly, wall thinning), functional changes (increased reliance on Frank-Starling mechanisms), and cellular/molecular alterations (cytoskeletal remodeling, shifts in arterio-venous electrolyte balances).This study encompassed three major phases: 1) Development of an ovine model of CHF to serve as an experimental platform; 2) Implantation of a left ventricular assist device (LVAD) in the CHF animals to investigate the role of acute ventricular unloading on myocardial oxygen consumption (LVVO2) and arterio-venous electrolyte balances as a therapy for CHF; 3) Investigations into the temporal and spatial alterations of the cytoskeletal protein desmin and its relationship to the ventricular remodeling cascade.Sheep underwent microembolization of the circumflex coronary artery until left ventricular ejection fraction (EF) decreased to To investigate the role of regional stimuli and determine whether remodeling processes are differentially regulated or evolve in concert with each other, we mapped the temporal and spatial distribution of intracellular (desmin content), extracellular (fibrosis content), and cellular (myocyte hypertrophy) remodeling in our ovine model of CHF and found that these remodeling processes dissociate from each other during the progression of CHF and are heterogeneously distributed in response regional stressors.

Published
2008

30. Left ventricular assist device explantation after myocardial recovery.

Author

Gallo M, Trivedi JR, Monreal G, Birks EJ, and Slaughter MS

Subjects
Equipment Failure, Female, Heart Failure physiopathology, Humans, Middle Aged, Device Removal methods, Heart Failure surgery, Heart-Assist Devices adverse effects, Myocardial Contraction physiology, Recovery of Function
Abstract

Left ventricular assist device (LVAD) treatment may lead to reverse remodeling in heart failure patients. Selected patients can recover heart function and be eligible for LVAD explantation. Surgical methods for explanting an LVAD have been reported using various surgical accesses and different degrees of retained device material. We report a surgical technique for achieving a complete pump removal, with an emphasis on the technical details of inflow and outflow pump cannula management., (© The Author 2016. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

Published
2018
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31. The In Vivo Skills Laboratory in Anesthesiology Residency Training.

Author

Monreal G, Moran KR, and Gerhardt MA

Abstract

Background: Anesthesiologists routinely perform high-risk procedures that are associated with permanent disability or death. Critical perioperative events require that the anesthesiologist perform procedures that are only used intermittently. Teaching these procedures is complicated by their infrequency and pressure to maximize operating room efficiency; therefore we created an annual 1-day anesthesiology skills lab as an innovative method of residency education., Methods: Anesthetized pigs served as the educational platform for first-year anesthesiology residents to gain hands-on experience performing regional, thoracic, vascular, and difficult airway techniques. A 20-question test was administered pre- and post-lab to assess the effectiveness of our educational intervention. Participants evaluated the quality of the educational experience (1-poor to 5-excellent)., Results: First-year anesthesiology residents participated (n=70, 2008-2012). Residents' pre-test scores measured 50.3±2.6% (range 20-80). Following lab participation, their test scores signi ficantly improved to a mean of 84.2±1.9% (range 45-100, p<0.0001). Participants increased their knowledge and skills (mean 4.96±0.02), considered the skills lab to be a worthwhile educational experience (mean 4.99±0.01), and agreed that the lab should be repeated in the future (mean 5.00)., Conclusions: In vivo labs confers educational benefits which are both perceived and self-reported by the participants and objectively demonstrated by marked improvements in their post-test scores. Animal models provide high-fidelity tactile learning, real-time physiological changes, and potential for complications which builds residents' familiarity and confidence with anesthesiology-related procedures and crisis events that would otherwise involve potential patient risk. Our lab is an enriching and well-received educational tool which promotes our goal of improving patient safety.

Published
2014

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