Clinical Research News 2010
News from Dr. Spotnitz's Laboratory
Dr. Spotnitz's laboratory is conducting research under a five year $3.3 million NIH grant entitled, "Biventricular Pacing After Cardiopulmonary Bypass."
This grant supports both the BiPACS (Biventricular Pacing After Cardiac Surgery) and the BiBET (Biventricular Pacing BEfore Transplantation) trials.
Currently in its fourth year, the BiPACS trial, under an IDE from the FDA and aided by indispensable collaboration from our cardiothoracic surgeons has demonstrated that cardiac output increases 10-15% with biventricular pacing at three time points in the first 24 hours after surgery for acquired heart disease on cardiopulmonary bypass.
BiPACS has been expanded to UCLA, seeking an accelerated answer to the primary question of whether cardiac output improves overall in paced patients and what clinical benefits and cost reductions result.
Pacing protocols developed under the BiPACS trial are further being tested in patients with right ventricular failure after cardiopulmonary bypass in an effort to expand the benefits of this technology.
These studies include adults and children undergoing cardiac transplantation and adults undergoing pulmonary thromboendartereectomy.
Multisite pacing studies are also under way in children undergoing surgery for single ventricle physiology.
Transcatheter Aortic Valve Replacement as Good as Open Surgery, According to PARTNER Results
Under the leadership of NewYork-Presbyterian Hospital's Division of Cardiothoracic Surgery, Transcatheter aortic valve implantation (TAVI) has been under study as a less invasive alternative for patients with severe aortic disease who are too sick or old to undergo surgical valve replacement.
The most recent results of the landmark PARTNER study show that TAVI is as good as open surgery in terms of long-term survival.
Craig R. Smith, MD, Principal Investigator of the PARTNER study, presented long-awaited results of cohort A to the American College of Cardiology 2011 Scientific Summit in New Orleans April 3, 2011.
Results of the first phase of the PARTNER trial, cohort B, were presented in December 2010.
Dr. Smith said in a statement that transcatheter aortic valve replacement "is the most exciting new treatment for aortic stenosis in the past two to three decades."
PARTNER Trial Results Are Big News at TCT Conference
Craig Smith, MD
PARTNER (Placement of Aortic Transcatheter valves) clinical trial Principal Investigators, including Craig Smith, MD, presented groundbreaking one-year data published in the New England Journal of Medicine at the 22nd Annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, which took place on September 21-25, 2010 in Washington, DC.
Their results confirm that less-invasive heart valve replacements significantly lower rates of death in comparison to standard therapy for certain patients.
The story received coverage in The New York Times, The Wall Street Journal, USA Today, Newsday, The Associated Press, Bloomberg.com, BusinessWeek.com, CBC.ca, MedPageToday.com, ModernMedicine.com and TopNews.co.uk.
Machine Perfusion Outperforms Standard Cold-Storage Liver Preservation
James V. Guarrera, MD
Preserving organs on ice prior to transplantation, an approach known as cold storage or CS, has been the standard practice in liver transplant for 20 years.
Now there is new evidence that a technique called hypothermic machine perfusion (HMP) may offer an improvement, according to the first-ever study comparing the impact of the two techniques on transplant outcomes.
The phase I study was carried out by Dr. James Guarrera and his colleagues at NewYork-Presbyterian Hospital/Columbia University Medical Center. Unlike cold storage, which Dr. Guarrera describes as a static technique, HMP dynamically simulates "aliveness" by providing a continuous flow of oxygen and key nutrients to the liver while diluting and removing toxins and waste products.
Laboratory research at Columbia is yielding new treatment options for some of the most difficult-to-treat tumors in children.
Cancer treatments involve multiple agents, and most recently, drugs that target very specific parts of the cancer growth process have moved to the forefront of researchers' attention.
Of these, a highly fruitful approach is one that blocks angiogenesis, the growth of the blood vessel sthat supply tumors.