Papers by Michael Siegenthaler
Perfusion, 2017
Introduction:This study explored the nature of the association between intraoperative usage of re... more Introduction:This study explored the nature of the association between intraoperative usage of red blood cell, fresh frozen plasma, cryoprecipitate or platelet transfusions and acute kidney injury.Methods:A total of 1175 patients who underwent cardiac surgery between 2008 and 2013 were retrospectively analyzed. We assessed the association between: (1) preoperative patient characteristics and acute kidney injury, (2) intraoperative blood product usage and acute kidney injury, (3) acute kidney injury and 30-day mortality or re-hospitalization.Results:In our cohort of 1175 patients, 288 patients (24.5%) developed acute kidney injury. This included 162 (13.8%), 69 (5.9%) and 57 (4.9%) developing stage 1, stage 2 or stage 3 acute kidney injury, respectively. Increased red blood cell, fresh frozen plasma or platelet transfusions increased the odds of developing acute kidney injury. Specifically, every unit of red blood cells, fresh frozen plasma or platelets transfused was associated with...
The Journal of Thoracic and Cardiovascular Surgery, 2004
The Journal of Thoracic and Cardiovascular Surgery, 2012
European Journal of Cardio-Thoracic Surgery, 2006
European Journal of Cardio-Thoracic Surgery, 2003
European Journal of Cardio-Thoracic Surgery, 2008
European Heart Journal, 2005
The Annals of Thoracic Surgery, 2009
The Annals of Thoracic Surgery, 2005
The Annals of Thoracic Surgery, 2003
European Journal of Cardio-Thoracic Surgery, 2002
European Journal of Pediatrics, 2012
An asymptomatic young woman was discovered to have life-threatening aneurysms and dissection of t... more An asymptomatic young woman was discovered to have life-threatening aneurysms and dissection of the thoracic aorta during routine evaluation in a Turner syndrome (TS) study. The presence of a heart murmur and hypertension had led to diagnosis and surgical repair of an atrial septal defect at age 5 and of aortic coarctation at age 12 years. The diagnosis of TS was made at age 16 year due to short stature and delayed pubertal development. She was treated with growth hormone from age 16-18 year, and with atenolol, thyroid hormone and estrogen. She discontinued her medications and was lost to medical follow-up at age 20 year. On presenting here at age 26 year, she reported a very active lifestyle, including vigorous exercise and an acting career, with no symptoms of chest or back pain or shortness of breath. Cardiovascular imaging revealed aortic regurgitation, an unsuspected dissection of a severely dilated ascending aorta, and a large descending aortic aneurysm. She required surgical replacement of her aortic valve and ascending aorta, followed by endovascular repair of the descending aortic aneurysm. Conclusion: This patient illustrates the importance of considering the diagnosis of TS in girls with congenital aortic defects and the absolute necessity for close, expert follow-up of these patients who are at high risk for complications after surgical repair due to an underlying aortopathy, hypertension and metabolic disorders. This patient also emphasizes the need to publicize and follow screening guidelines as an increasing number of patients with congenital defects transition to adult care.
European Journal of Cardio-Thoracic Surgery, 2009
Objective: We tested the hypothesis that a miniaturised axial flow pump with infection-resistant ... more Objective: We tested the hypothesis that a miniaturised axial flow pump with infection-resistant power delivery could improve longevity and quality of life (QOL) in advanced heart failure patients deemed unsuitable for transplantation. Methods: The study included all non-United States Jarvik 2000 patients (n = 46), where a skull-pedestal-based power line was employed with the intention of long-term support. Patient age ranged from 29 to 80 years. Of the 46 patients, 42 were male. All were New York Heart Association (NYHA) IV predominantly with idiopathic dilated (n = 22) or ischaemic (n = 18) cardiomyopathy. The experience (2000-2008) included the learning curve of 10 centres. Results: The internal components are imperceptible. The power/control system is user friendly, allowing excellent QOL. There has been no pump malfunction. The Kaplan-Meier survival analysis is shown. The longest event-free survival is 7.5 years. Support exceeded 3 years in five cases. The cumulative experience exceeds 50 years. Three patients were transplanted, and two pumps were replaced at 90 and 203 days. Nineteen cases are ongoing (mean: 663 days), while 22 died during support (mean survival: 402 days), of which five from non-device-related diseases. Temporary local infection occurred in three pedestals, and there has been no pump infection. Incidence of thrombo-embolic events showed wide variation between centres. Conclusions: From this learning-curve experience, both left ventricular assist device (LVAD) and power delivery are reliable and promising for destination therapy. Early mortality is similar to other studies and relates to the severity of illness. Pump infection has not occurred and prolonged event-free survival is clearly possible with expert medical management.
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Papers by Michael Siegenthaler