Browsing by Author "Wang, I.-Wen"

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    Left ventricular thrombus associated with arteriovenous extra corporeal membrane oxygenation
    (Pioneer Bioscience Publishing Company, 2015-11) Makdisi, George; Hashmi, Zubair A.; Wozniak, Thomas C.; Wang, I.-Wen; Department of Surgery, IU School of Medicine
    Extra corporeal membrane oxygenation (ECMO) has remarkably progressed over the recent years. It has become an invaluable tool in the care of adults and pediatric patients with severe cardiogenic shock. At the initiation of ECMO support, the left ventricular contractility is profoundly impaired. Inadequate right ventricular drainage and bronchial circulation can lead to left ventricular distension, with potential deleterious consequences, ranging from inadequate myocardial rest, pulmonary edema, or intracardiac clot formation. Therefore, it is of extreme importance to ensure an adequate left ventricular drainage. Here we present a case of LV thrombus developed while the patient is on central venoarterial (VA) ECMO.
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    Minimally invasive is the future of left ventricular assist device implantation
    (Pioneer Bioscience Publishing Company, 2015-09) Makdisi, George; Wang, I.-Wen; Department of Surgery, IU School of Medicine
    There have been many factors that have allowed for progressive improvement in outcomes and lower complication rates. These include the improvement in left ventricular assist device (LVAD) technologies, combined with better understanding of patient management, all these. Nowadays the numbers of LVAD implantations exceed the number of annual heart transplants worldwide. Minimally invasive procedures are shown to improve the surgical outcome in both LVAD insertion and replacement. These minimally invasive techniques can be grouped grossly into shifting from on-pump to off-pump implantation, alternative access for implantation other than sternotomy, and a combination of both, which should be the ultimate aim of minimally invasive LVAD implantation. Here we describe the alternative techniques and configurations of minimally invasive and sites of implantation.
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    Severe epistaxis in patients on extracorporeal membranous oxygenator support occurrence and management
    (Pioneer Bioscience Publishing Company, 2015-11) Makdisi, George; Wang, I.-Wen; Department of Surgery, IU School of Medicine