Author
Ivan Aleksic
Other affiliations: Cedars-Sinai Medical Center, University of California, Los Angeles
Bio: Ivan Aleksic is an academic researcher from University of Göttingen. The author has contributed to research in topics: Transplantation & Heart transplantation. The author has an hindex of 18, co-authored 70 publications receiving 900 citations. Previous affiliations of Ivan Aleksic include Cedars-Sinai Medical Center & University of California, Los Angeles.
Papers published on a yearly basis
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TL;DR: Surgical closure of congenital coronary artery fistulas in adults can be performed with a very low risk, and closure is recommended to prevent complications.
80 citations
TL;DR: Conversion from azathioprine to MMF with consecutive reduction of CsA in heart transplant recipients with CsSA-impaired renal function improves renal function as evidenced by lower serum creatinine, urea nitrogen, uric acid, and higher creat inine clearance.
Abstract: BACKGROUND Cyclosporine (CsA) nephrotoxicity is a common problem after cardiac transplantation. We have studied the impact of CsA dose reduction in association with mycophenolate mofetil (MMF) treatment on renal function in heart transplant recipients with suspected CsA nephrotoxicity (serum creatinine level >2 mg/dl). METHODS Twelve heart transplant recipients (11 men, 1 woman; 111 to 1813 days after transplantation) with CsA-based immunosuppression (plus azathioprine and/or steroids) and a serum creatinine level >2.0 mg/dl were started on a daily dose of 2000 mg of MMF. Dilated cardiomyopathy was the underlying disease in nine patients, ischemic cardiomyopathy in three patients. Mean patient age was 57 years (range 44-69 years). Azathioprine was discontinued and CsA slowly tapered. Creatinine clearance, serum creatinine level, urea nitrogen, and uric acid were monitored. CsA levels were measured, and CsA dose was adjusted for whole blood levels of 70-120 microg/L. Ten patients still had endomyocardial biopsies, whereas one had echocardiographic controls only. RESULTS One grade 1B rejection episode according to ISHLT (International Society for Heart and Lung Transplantation) was observed until 1 year after the switch to MMF. One patient was excluded due to gastrointestinal side effects. CONCLUSIONS Conversion from azathioprine to MMF with consecutive reduction of CsA in heart transplant recipients with CsA-impaired renal function improves renal function as evidenced by lower serum creatinine, urea nitrogen, uric acid, and higher creatinine clearance.
65 citations
TL;DR: Based on this experience, it is believed this modified technique for orthotopic heart transplantation has an anatomic and physiologic advantage that may improve long-term hemodynamic results.
45 citations
TL;DR: In human atrial and ventricular myocardium the positive force-frequency relation results from increased SR Ca(2+) turnover, which may be due to rest-dependent SR Ca (2+) loss (Ca( 2+) leak) and subsequent Ca(1+) extrusion via Na(+)/Ca(2-) exchange.
Abstract: Physiologically, human atrial and ventricular myocardium are coupled by an identical beating rate and rhythm. However, contractile behavior in atrial myocardium may be different from that in ventri...
45 citations
TL;DR: Intra-aortic balloon pump removal and thrombectomy is usually sufficient to provide revascularization, and identification of subclinical disease may aid in the management of subsequent acute limb ischaemia.
43 citations
Cited by
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National Heart Foundation of Australia1, University of Toronto2, Cleveland Clinic3, University of Chicago4, University of Alberta5, Inova Fairfax Hospital6, Ochsner Health System7, University of Alabama at Birmingham8, Newcastle upon Tyne Hospitals NHS Foundation Trust9, Ludwig Maximilian University of Munich10, Saint Barnabas Medical Center11, Duke University12, Primary Children's Hospital13, University of Pittsburgh14, University of Utah15, University of Maryland, Baltimore16, University of Vienna17, Stanford University18, University College London19, Washington University in St. Louis20, Loma Linda University21, University of A Coruña22, The Texas Heart Institute23, Katholieke Universiteit Leuven24, Northwestern University25, University of Wisconsin-Madison26, Yeshiva University27, Cincinnati Children's Hospital Medical Center28, University of Colorado Denver29, Drexel University30, University of Pennsylvania31, Mayo Clinic32, St Vincent Hospital33, Papworth Hospital34, Emory University35, Johns Hopkins University36
TL;DR: Institutional Affiliations Chair Costanzo MR: Midwest Heart Foundation, Lombard Illinois, USA Task Force 1 Dipchand A: Hospital for Sick Children, Toronto Ontario, Canada; Starling R: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Starlings R: University of Chicago, Chicago, Illinois,USA; Chan M: university of Alberta, Edmonton, Alberta, Canada ; Desai S: Inova Fairfax Hospital, Fairfax, Virginia, USA.
Abstract: Institutional Affiliations Chair Costanzo MR: Midwest Heart Foundation, Lombard Illinois, USA Task Force 1 Dipchand A: Hospital for Sick Children, Toronto Ontario, Canada; Starling R: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Anderson A: University of Chicago, Chicago, Illinois, USA; Chan M: University of Alberta, Edmonton, Alberta, Canada; Desai S: Inova Fairfax Hospital, Fairfax, Virginia, USA; Fedson S: University of Chicago, Chicago, Illinois, USA; Fisher P: Ochsner Clinic, New Orleans, Louisiana, USA; Gonzales-Stawinski G: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Martinelli L: Ospedale Niguarda, Milano, Italy; McGiffin D: University of Alabama, Birmingham, Alabama, USA; Parisi F: Ospedale Pediatrico Bambino Gesu, Rome, Italy; Smith J: Freeman Hospital, Newcastle upon Tyne, UK Task Force 2 Taylor D: Cleveland Clinic Foundation, Cleveland, Ohio, USA; Meiser B: University of Munich/Grosshaden, Munich, Germany; Baran D: Newark Beth Israel Medical Center, Newark, New Jersey, USA; Carboni M: Duke University Medical Center, Durham, North Carolina, USA; Dengler T: University of Hidelberg, Heidelberg, Germany; Feldman D: Minneapolis Heart Institute, Minneapolis, Minnesota, USA; Frigerio M: Ospedale Niguarda, Milano, Italy; Kfoury A: Intermountain Medical Center, Murray, Utah, USA; Kim D: University of Alberta, Edmonton, Alberta, Canada; Kobashigawa J: Cedar-Sinai Heart Institute, Los Angeles, California, USA; Shullo M: University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Stehlik J: University of Utah, Salt Lake City, Utah, USA; Teuteberg J: University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Uber P: University of Maryland, Baltimore, Maryland, USA; Zuckermann A: University of Vienna, Vienna, Austria. Task Force 3 Hunt S: Stanford University, Palo Alto, California, USA; Burch M: Great Ormond Street Hospital, London, UK; Bhat G: Advocate Christ Medical Center, Oak Lawn, Illinois, USA; Canter C: St. Louis Children Hospital, St. Louis, Missouri, USA; Chinnock R: Loma Linda University Children's Hospital, Loma Linda, California, USA; Crespo-Leiro M: Hospital Universitario A Coruna, La Coruna, Spain; Delgado R: Texas Heart Institute, Houston, Texas, USA; Dobbels F: Katholieke Universiteit Leuven, Leuven, Belgium; Grady K: Northwestern University, Chicago, Illlinois, USA; Kao W: University of Wisconsin, Madison Wisconsin, USA; Lamour J: Montefiore Medical Center, New York, New York, USA; Parry G: Freeman Hospital, Newcastle upon Tyne, UK; Patel J: Cedar-Sinai Heart Institute, Los Angeles, California, USA; Pini D: Istituto Clinico Humanitas, Rozzano, Italy; Pinney S: Mount Sinai Medical Center, New York, New York, USA; Towbin J: Cincinnati Children's Hospital, Cincinnati, Ohio, USA; Wolfel G: University of Colorado, Denver, Colorado, USA Independent Reviewers Delgado D: University of Toronto, Toronto, Ontario, Canada; Eisen H: Drexler University College of Medicine, Philadelphia, Pennsylvania, USA; Goldberg L: University of Pennsylvania, Philadelphia, Pennsylvania, USA; Hosenpud J: Mayo Clinic, Jacksonville, Florida, USA; Johnson M: University of Wisconsin, Madison, Wisconsin, USA; Keogh A: St Vincent Hospital, Sidney, New South Wales, Australia; Lewis C: Papworth Hospital Cambridge, UK; O'Connell J: St. Joseph Hospital, Atlanta, Georgia, USA; Rogers J: Duke University Medical Center, Durham, North Carolina, USA; Ross H: University of Toronto, Toronto, Ontario, Canada; Russell S: Johns Hopkins Hospital, Baltimore, Maryland, USA; Vanhaecke J: University Hospital Gasthuisberg, Leuven, Belgium.
1,346 citations
University of Kentucky1, Dartmouth College2, Washington University in St. Louis3, Wake Forest University4, Anschutz Medical Campus5, Oregon Health & Science University6, Society of Thoracic Surgeons7, Yeshiva University8, Stanford University9, University of Toronto10, Englewood Hospital and Medical Center11, Duke University12, University of Pittsburgh13, Flinders University14, Harvard University15
TL;DR: Much has changed since the previously published 2007 STS blood management guidelines and this document contains new and revised recommendations.
1,090 citations
533 citations
Royal Melbourne Hospital1, Yale University2, European University3, Cedars-Sinai Medical Center4, University of Parma5, Icahn School of Medicine at Mount Sinai6, University of Duisburg-Essen7, Federal University of São Paulo8, Pennsylvania State University9, University of Paris10, Boston University11, Leipzig University12, Imperial College London13, University of Michigan14, Korea University Medical Center15, University of Birmingham16, University of California, San Francisco17, Vanderbilt University18, University of Tsukuba19, Royal Adelaide Hospital20, Cleveland Clinic21, McGill University22
TL;DR: The working group proposes the following working definition of atrial cardiomyopathy: ‘Any complex of structural, architectural, contractile or electrophysiological changes affecting the atria with the potential to produce clinically-relevant manifestations’ (Table 1).
530 citations
University of Brescia1, Karolinska Institutet2, University of Zagreb3, Athens State University4, Papworth Hospital5, Utrecht University6, Shaare Zedek Medical Center7, Medical University of Vienna8, Ege University9, University of Bologna10, Heidelberg University11, Poznan University of Medical Sciences12, University of Cambridge13, University of Zurich14
TL;DR: There is an urgent need to develop evidence‐based treatment algorithms to prolong life when possible and in accordance with patient preferences, increase life quality, and reduce the burden of hospitalization in this vulnerable patient population.
Abstract: This article updates the Heart Failure Association of the European Society of Cardiology (ESC) 2007 classification of advanced heart failure and describes new diagnostic and treatment options for these patients. Recognizing the patient with advanced heart failure is critical to facilitate timely referral to advanced heart failure centres. Unplanned visits for heart failure decompensation, malignant arrhythmias, co-morbidities, and the 2016 ESC guidelines criteria for the diagnosis of heart failure with preserved ejection fraction are included in this updated definition. Standard treatment is, by definition, insufficient in these patients. Inotropic therapy may be used as a bridge strategy, but it is only a palliative measure when used on its own, because of the lack of outcomes data. Major progress has occurred with short-term mechanical circulatory support devices for immediate management of cardiogenic shock and long-term mechanical circulatory support for either a bridge to transplantation or as destination therapy. Heart transplantation remains the treatment of choice for patients without contraindications. Some patients will not be candidates for advanced heart failure therapies. For these patients, who are often elderly with multiple co-morbidities, management of advanced heart failure to reduce symptoms and improve quality of life should be emphasized. Robust evidence from prospective studies is lacking for most therapies for advanced heart failure. There is an urgent need to develop evidence-based treatment algorithms to prolong life when possible and in accordance with patient preferences, increase life quality, and reduce the burden of hospitalization in this vulnerable patient population.
507 citations