Lankenau Medical Center

About: Lankenau Medical Center is a healthcare organization based out in Philadelphia, Pennsylvania, United States. It is known for research contribution in the topics: Atrial fibrillation & Medicine. The organization has 436 authors who have published 414 publications receiving 7095 citations. The organization is also known as: Lankenau Hospital.

Left ventricular assist device implantation in high risk destination therapy patients: an alternative surgical approach

Abstract: Left Ventricular Assist Device (LVAD) for Destination Therapy (DT) is an established therapy for end stage heart failure patients who are not transplant candidates. Many DT patients requiring LVADs have had prior open heart surgery, the majority of whom had prior sternotomy. In addition, DT patients tend to be older and more likely to have more significant co-morbidities than their Bridge-To-Transplant (BTT) counterparts. As such, placement of an implantable LVAD in DT patients can be technically hazardous and potentially prone to more perioperative complications. The purpose of this report is to describe an alternative implantation approach for the implantation of the Heartmate II™ LVAD in high risk DT patients.

Changing trends in diabetes mellitus in pregnancy.

Abstract: The purpose of this study was to identify any changing trends in the incidence and caesarean section (CS) rate of pre-gestational diabetes mellitus (DM) and gestational diabetes mellitus (GDM) over a 10- year period, between 1999 and 2008. Although the incidence of pre-gestational DM has not significantly changed over the course of the last 10 years, there is an obvious rising trend in the incidence of GDM. Despite an increase in the overall CS rate during this time period, a parallel increase in the CS rate has not been observed among women whose pregnancies are complicated either by gestational or by pre-gestational diabetes (PGD).

Initial clinical experience with Single-Port robotic (SP r) left colectomy using the SP surgical system: description of the technique

Abstract: The daVinci Single-Port (SP) robot is a new robotic platform designed to overcome the challenges of Single-Incision Laparoscopic Surgery. The objective of this study is to demonstrate the feasibility and technical aspects of SP robotic (SP r) left colectomy using the SP platform. Under Institutional Review Board approval and registration on ClinicalTrials.gov, we performed SP rLeft colectomy using the daVinci SP surgical system on four patients. The primary end-point of this study was to report and describe the technical feasibility to perform SP rLeft colectomy. The secondary end-points included perioperative metrics and outcomes. Four patients underwent successful SP rLeft colectomy for diverticulitis through a single incision (average size: 4.4 cm) without intraoperative complications or conversions. The robot was docked 2.7 times on average (range 2–4). The average docking time was 8.4 min (range: 3–33 min). The mean estimated blood loss was 91 mL (range: 20–250 mL). There were no morbidities or mortalities. Patients were discharged on POD 2 and 3. We demonstrated in this initial clinical series the SP rLeft colectomy to be feasible and safe to perform in select patients. The SP robot’s single-arm design and flexible instruments have shown to provide excellent visualization and retraction with minimal collisions. We predict that the SP robot will be widely utilized in the field of colorectal surgery as it becomes available to colorectal surgeons. Further experience and larger studies are needed to define the advantages and identify the problems with the SP rLeft colectomy.

Facilitating technologies in minimally invasive aortic valve replacement: a propensity score analysis.

Abstract: Objectives Minimally invasive aortic valve replacement (MIAVR) can be technically demanding and may lead to prolonged operative time. We evaluated the intraoperative and postoperative patient outcomes following implementation of 2 facilitating technologies (FT) in MIAVR: the Cor-Knot titanium fastener and Custodiol-histidine-tryptophan-ketoglutarate solution. Methods A total of 299 patients underwent MIAVR from 2008 to 2016; 172 (57.5%) patients were included in the FT group and 127 (42.5%) patients in the control group (No-FT). We performed a propensity score analysis, matching 94 pairs. Primary end points were cardiopulmonary bypass and cross-clamp times. Secondary end points were blood product utilization, postoperative ejection fraction, intensive care unit and hospital lengths of stay, the in-hospital mortality rate and the incidence of stroke, sepsis, renal failure, atrial fibrillation, pulmonary embolism, pneumonia and prolonged mechanical ventilator support. Results The 2 matched groups had similar baseline characteristics. Significant reductions in cardiopulmonary bypass (104 ± 22 vs 118 ± 30 min, P 0.49). Conclusions FT decreased intraoperative times, intraoperative red blood cell and cryoprecipitate transfusions, the need for prolonged mechanical ventilator support, renal failure and hospital length of stay. Using FT in MIAVR will allow for more reproducible, widespread adoption of minimally invasive approaches for aortic valve replacement.