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314 results on '"Trivedi, Jaimin R."'

21. Amiodarone Use and All‐Cause Mortality in Patients With a Continuous‐Flow Left Ventricular Assist Device

Author

Gopinathannair, Rakesh, primary, Pothineni, Naga Venkata K., additional, Trivedi, Jaimin R., additional, Roukoz, Henri, additional, Cowger, Jennifer, additional, Ahmed, Mustafa M., additional, Bhan, Adarsh, additional, K. Ravichandran, Ashwin, additional, Bhat, Geetha, additional, Al Ahmad, Amin, additional, Natale, Andrea, additional, Di Biase, Luigi, additional, Slaughter, Mark S., additional, and Lakkireddy, Dhanunjaya, additional

Published
2022
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29. Minimally Invasive Esophagectomy Is Associated with Superior Survival Compared to Open Surgery

Author

Ising, Mickey S., Smith, Susan A., Trivedi, Jaimin R., Martin, Robert C.G., Phillips, Prejesh, Van Berkel, Victor, and Fox, Matthew P.

Abstract

Introduction Minimally invasive esophagectomy (MIE) has not been associated with a long-term survival advantage compared to open esophagectomy (OE). We investigated survival differences between MIE, including laparoscopic and robotic, and OE.Methods Patients undergoing esophagectomy from 2010 to 2014 with T1-4N0-3M0, adenocarcinoma or squamous cell histology, in middle or lower esophagus were queried from the National Cancer Database and stratified into groups based on their surgical procedure: robotic, laparoscopic, or OE. Propensity matching (1:1) was done between robotic and laparoscopic to produce an MIE group. The MIE group was matched to OE yielding a 1:1:2 matching of robotic:laparoscopic:OE. Postoperative outcomes and survival (Kaplan-Meier) were compared between groups.Results Prior to matching, 7,163 patients met inclusion criteria and a greater portion underwent OE (67.7%) than MIE (laparoscopic 24.9% and robotic 7.4%). Matching yielded similar groups (robotic = 527, laparoscopic = 527, and OE =1054). Compared to OE, MIE patients had a significantly greater number of nodes sampled and trended toward increased R0 resections (96.1% vs 94.3%, P= .053). OE was associated with a longer median postoperative stay (10 vs 9 days, P= .001). Mortality at 30 and 90 days was similar.However, postoperative survival for MIE was significantly greater than OE (P< .001). No survival difference existed between robotic and laparoscopic (P= .723).Conclusions MIE is associated with increased number of nodes examined and a shorter postoperative length of stay. After propensity matching, patients undergoing MIE had better long but not short-term survival than OE. This benefit seems to be independent of the use of robotic technology.

Published
2023
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39. Contemporary outcomes of durable ventricular assist devices in adults with congenital heart disease as a bridge to heart transplantation.

Author

Das, Bibhuti B., Kogon, Brian, Deshpande, Shriprasad R., Slaughter, Mark S., and Trivedi, Jaimin R.

Subjects
HEART assist devices, HEART, HEART transplantation, CONGENITAL heart disease, HEART transplant recipients, SURVIVAL rate, ADULTS
Abstract

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 a ventricular assist device (VAD) versus no‐VAD. Methods: The study included 894 ACHD patients aged ≥18 years listed for primary heart transplantation between 2010 and 2019 from the United Network for Organ Sharing database. Primary outcomes were waitlist and 1‐year post‐transplant mortality between VAD and no‐VAD ACHD patients. Results: Of 894 ACHD patients included in the study, 91(10.1%) had VAD support at the time of listing. Patients who needed VAD support were mostly males, heavier, and had higher pulmonary artery pressure than the no‐VAD group at the listing. The overall waitlist mortality was 38% in the VAD group than 17% in the no‐VAD group (p < 0.01). ECMO use was associated with significantly higher mortality than either group. There was no significant difference in 1‐year post‐transplant mortality between VAD versus no‐VAD at the time of transplant (15% vs. 17%; p = 0.66). Multivariate regression analysis found that BMI <20 kg/m2 (hazard ratio (HR) 1.1; p = 0.01), bilirubin >2 mg/dl (HR 1.1; p = 0.03), creatinine >2 mg/dl (HR 1.3; p = 0.04) and ECMO at transplant (HR 1.4; p = 0.03) increased early post‐transplant mortality. Conclusions: The one‐year post‐transplant mortality rate was no different for ACHD patients that received VAD versus no‐VAD. These findings suggest that a VAD should be considered an option to support ACHD patients as a bridge to heart transplantation. [ABSTRACT FROM AUTHOR]

Published
2022
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47. A Tale of Two Centrifugal-Flow Ventricular Assist Devices As Bridge to Heart Transplant.

Author

Alwair, Hazaim, Whitehouse, Katherine, Slaughter, Mark S., and Trivedi, Jaimin R.

Abstract

Use of continuous-flow left ventricular assist devices (LVAD) has increased over the years as a bridge to transplant. The HeartWare HVAD (Medtronic, Minneapolis, MN) and HeartMate III (HM3, Abbott, Abbott Park, IL) are currently approved centrifugal-flow devices used for bridge to transplant. We sought to evaluate outcomes of the patients listed and who received a transplant after receiving these 2 devices. The United Network of Organ Sharing thoracic transplant database was queried after August 23, 2017, until December 2018 to identify patients aged older than 18 years listed for heart transplant and supported by the HVAD or HM3. Patient characteristics were evaluated at the time of listing and transplant. The primary study end point was 1-year mortality after LVAD implantation. Nonparametric tests were used to evaluate the device groups. Of 569 patients listed for heart transplant during the study period, 226 had HM3 and 343 had HVAD. The HM3 group had more men (82% vs 74%, P =.02), patients with diabetes (38% vs 29%, P =.02), and the body mass index was higher (28 vs 27 kg/m2, P =.04) at listing. Between the HM3 and HVAD groups, the 1-year mortality was 20% vs 17%, respectively (log-rank P =.28; Figure 1), and the posttransplant survival at 1 year was 97% and 94%, respectively (P =.1). In a relatively well-matched group of patients listed for heart transplant with a centrifugal-flow LVAD, the 6-month and 1-year mortality on the waiting list as well as after transplant were not statistically different. Additional real-world experience or a randomized trial would be needed to determine whether one LVAD is superior. [ABSTRACT FROM AUTHOR]

Published
2022
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