Simon Maltais

Bio: Simon Maltais is an academic researcher from Mayo Clinic. The author has contributed to research in topics: Ventricular assist device & Heart failure. The author has an hindex of 32, co-authored 193 publications receiving 3507 citations. Previous affiliations of Simon Maltais include Vanderbilt University & Université de Sherbrooke.

Burden of Tricuspid Regurgitation in Patients Diagnosed in the Community Setting.

Abstract: Objectives This study sought to analyze patients with tricuspid regurgitation (TR) diagnosed in the community setting (Olmsted County) by Doppler echocardiography to define the prevalence, characteristics, and implications of clinically significant (greater or equal to moderate) TR. Background The prevalence, cause distribution, and significance of TR are mostly unknown. Methods All adult residents of Olmsted County, Minnesota, who underwent clinically indicated Doppler echocardiography between 1990 and 2000 were evaluated for presence of greater or equal to moderate TR. The characteristics and outcome of TR carriers was then analyzed. Results During the study period, 417 community residents were diagnosed with greater or equal to moderate TR corresponding to an U.S. age- and sex-adjusted prevalence of 0.55% with 95% confidence interval (0.50 to 0.60). TR adjusted prevalence was higher in women (p Conclusions Clinically significant (greater or equal to moderate) TR is common in community residents diagnosed by Doppler echocardiography and increases with age. Isolated TR is associated with excess mortality, thus TR represents an important public health problem.

PREVENtion of HeartMate II Pump Thrombosis Through Clinical Management: The PREVENT multi-center study

Abstract: Background Recommended structured clinical practices including implant technique, anti-coagulation strategy, and pump speed management (PREVENT [ PREVEN tion of HeartMate II Pump T hrombosis Through Clinical Management] recommendations) were developed to address risk of early ( Methods PREVENT was a prospective, multi-center, single-arm, non-randomized study of 300 patients implanted with HMII at 24 participating sites. Confirmed PT (any suspected PT confirmed visually and/or adjudicated by an independent assessor) was evaluated at 3 months (primary end-point) and at 6 months after implantation. Results The population included 83% men (age 57 years ± 13), 78% destination therapy, and 83% Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Profile 1–3. Primary end-point analysis showed a confirmed PT of 2.9% at 3 months and 4.8% at 6 months. Adherence to key recommendations included 78% to surgical recommendations, 95% to heparin bridging, and 79% to pump speeds ≥9,000 RPMs (92% >8,600 RPMs). Full adherence to implant techniques, heparin bridging, and pump speeds ≥9,000 RPMs resulted in a significantly lower risk of PT (1.9% vs 8.9%; p p Conclusions Adoption of all components of a structured surgical implant technique and clinical management strategy (PREVENT recommendations) is associated with low rates of confirmed PT.

Evaluation of a lateral thoracotomy implant approach for a centrifugal-flow left ventricular assist device: The LATERAL clinical trial.

Abstract: BACKGROUND The HeartWare centrifugal-flow ventricular assist device system (HVAD) is a viable option for treatment of advanced heart failure There is a growing trend toward the use of less invasive techniques in cardiac surgery, and the thoracotomy technique for HVAD implantation may provide benefits not available with conventional approaches METHODS The LATERAL trial is a multicenter, prospective, non-randomized, single-arm trial that utilized data from 144 patients enrolled in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database at 26 centers in the United States and Canada The primary composite end-point was success at 180 days defined as alive on the originally implanted device and free from disabling stroke (modified Rankin Scale score >3), transplanted or explanted for recovery The key secondary end-point was mean length of initial hospital stay RESULTS The primary end-point was successfully achieved in 881% of patients and was significantly greater than the pre-defined performance goal of 775% set from historical sternotomy data (p = 00012) The key secondary end-point—mean length of initial hospital stay —was 18 days and was significantly shorter than the pre-defined performance goal of 261 days obtained from historical sternotomy data (p CONCLUSIONS This prospective clinical trial provides validation that implantation of the HVAD system via the thoracotomy approach used in the LATERAL study represents a safe and effective alternative to median sternotomy in selected patients intended for a bridge-to-transplant indication

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary

Abstract: s in PubMed), and more liberal use of summary recommendation tables (with references that support LOE) to serve as a quick reference. In April 2011, the Institute of Medicine released 2 reports: Finding What Works in Health Care: Standards for Systematic Reviews and Clinical Practice Guidelines We Can Trust.2,3 It is noteworthy that the IOM cited ACCF/AHA practice guidelines as being compliant with many of the proposed standards. A thorough review of these reports and of our current methodology is under way, with further enhancements anticipated. The recommendations in this guideline are considered current until they are superseded by a focused update or the fulltext guideline is revised. The reader is encouraged to consult the full-text guideline for additional guidance and details about the care of the patient with ST-elevation myocardial infarction (STEMI), because the Executive Summary contains only the recommendations. Guidelines are official policy of both the ACCF and AHA. Jeffrey L. Anderson, MD, FACC, FAHA Chair, ACCF/AHA Task Force on Practice Guidelines O’Gara et al 2013 ACCF/AHA STEMI Guideline Executive Summary 533