Scott C Silvestry

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Journals/Publications

• Abraham, J., Anderson, M., Silvestry, S., Soltesz, E. G., Ono, M., Mody, K., Esmailian, F., Kilic, A., Bharmi, R., Chhim, R., Bogaev-Chapman, R., Katlaps, G. J., Armas, I. S., Daneshmand, M. A., Kaczorowski, D. J., Pham, D. T., Ramzy, D., & D'Alessandro, D. (2025). Outcomes of Surgically Implanted Impella Microaxial Flow Pumps in Heart Failure-Related Cardiogenic Shock. Journal of cardiac failure.
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  Patients with cardiogenic shock (CS) are increasingly treated with high-profile microaxial flow pumps (Impella 5.5), but little is known about the indications and outcomes of this support strategy in patients with CS due to heart failure (HF-CS).
• Alam, A. H., Lee, C. Y., Kanwar, M. K., Moayedi, Y., Bernhardt, A. M., Takeda, K., Pham, D. T., Salerno, C., Zuckermann, A., D'Alessandro, D., Pretorius, V. G., Louca, J. O., Large, S., Bowles, D. E., Silvestry, S. C., & Moazami, N. (2025). Current approaches to optimize the donor heart for transplantation. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 44(4), 672-680.
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  Heart transplantation remains a critical therapy for patients with end-stage heart failure, offering incremental survival and improved quality of life. One of the key components behind the success of heart transplantation is the condition and preservation of the donor's heart. In this review, we provide a comprehensive overview of ischemic reperfusion injury, risk factors associated with primary graft dysfunction, current use of various preservation solutions for organ procurement, and recent advancements in donor heart procurement technologies. This state-of-the-art review will explore factors associated with bringing the "ideal" donor heart to the operating room in the contemporary era.
• Bernhardt, A. M., Blumer, V., Vandenbriele, C., Schrage, B., Mody, K., Pappalardo, F., Silvestry, S., Anderson, M., Abraham, J., Gage, A., Goldstein, D., Grant, M., Klipa, I., Schlöglhofer, T., Lim, S., Moller, J., Panholzer, B., Molina, E., Riebandt, J., , Uriel, N., et al. (2025). Clinical management of the Impella 5.5 pump. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 44(11), 1688-1702.
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  The Impella 5.5 (Abiomed, USA) is a catheter-based micro-axial flow pump that has emerged as a vital tool in managing patients with cardiogenic shock (CS). Delivering up to 5.5 L/min of flow, it enables full left ventricular (LV) support with beneficial hemodynamic and metabolic effects. Its unique advantages include high-flow, antegrade circulatory support with the potential for prolonged usage, making it suitable for bridging to recovery or heart replacement therapies. This manuscript provides a comprehensive, structured guide for the clinical management of patients supported with the Impella 5.5. It outlines best practices for patient selection, surgical implantation techniques-most commonly via the axillary artery-perioperative management, anticoagulation strategies, and postoperative monitoring. Special emphasis is placed on complication management, including bleeding, hemolysis, right ventricular dysfunction, stroke, aortic valve injury, and vascular complications. Technologies like SmartAssist and Impella Connect are highlighted for their utility in real-time device monitoring and remote management. The manuscript also discusses a three-phase framework for recovery: hemodynamic stabilization, initiation of guideline-directed medical therapy (GDMT), and structured weaning protocols. Considerations for transitioning patients to heart transplantation or durable LVADs, as well as explant techniques, are detailed. The importance of multidisciplinary coordination-including a mechanical circulatory support (MCS) coordinator-is emphasized to ensure optimal patient outcomes. By synthesizing available evidence and institutional experience, this guide aims to standardize Impella 5.5 management, reduce complications, and improve outcomes in critically ill patients with advanced heart failure or CS.
• Farhoud, H., Shah, Z., Dalia, T., Silvestry, S., Shah, H., Meyer, D., DʼAlessandro, D., & Vidic, A. (2025). Chilling Choices: Heart Transplant Outcomes Using SherpaPak With Long Ischemic Time Versus Traditional Ice Storage With Short Ischemic Time. ASAIO journal (American Society for Artificial Internal Organs : 1992), 71(4), 308-315.
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  We performed a retrospective review comparing outcomes between traditional ice storage (ICE) with short ischemic times (4 hours) using data from the GUARDIAN registry, a retrospective observational trial. To minimize baseline differences, propensity-matched (PSM) cohorts for site and era were performed. SherpaPak Cardiac Transport System travel distance was almost 10-fold greater than ICE (82 miles ICE vs . 765 miles SCTS). There was no significant difference in primary graft dysfunction (PGD) (20.8% vs. 18.2%, p = 0.58), length of stay (LOS) (24.7 vs. 24.8, p = 0.98), posttransplant mechanical circulatory support (MCS) (25.1% vs. 20.3%, p = 0.34), and 30 day survival (100% vs. 98.6%, p = 0.20). SherpaPak Cardiac Transport System showed statistically significant reduction in 24 hour inotrope scores (17.6 vs. 13.6, p = 0.007) and right ventricular (RV) dysfunction (31.1% vs. 15.7%, p = 0.002). Propensity-matched cohorts showed statistically similar rates of MCS utilization and PGD, but SCTS trended toward less RV dysfunction (26.0% vs. 16.2%, p = 0.11) and lower inotrope scores (16.5 vs. 12.9, p = 0.06) despite almost double the ischemic time. In conclusion, donor heart preservation with SCTS continues to be effective in prolonged ischemic times without sacrificing postheart transplantation clinical outcomes. This may aid in expanding donor organ geography.
• Kaczorowski, D. J., Takeda, K., Atluri, P., Cevasco, M., Cogswell, R., D'Allesandro, D., Daneshmand, M. A., Jeevanandam, V., Kapur, N. K., Milano, C., Ono, M., Potapov, E., Ramzy, D., Silvestry, S. C., Soltesz, E., & Uriel, N. (2025). 2025 American Association for Thoracic Surgery (AATS) Expert Consensus Document: Surgical management of acute myocardial infarction and associated complications. The Journal of thoracic and cardiovascular surgery, 170(5), 1327-1344.
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  Complications of acute myocardial infarction (AMI) can result in significant morbidity and mortality. This document reports the findings and recommendations of a multidisciplinary group of experts on the management of patients with complications of AMI, with particular focus on the use of mechanical circulatory support in this context.
• Lorusso, R., Salazar, L., Nersesian, G., Milojevic, M., Schmack, B., Engelman, D. T., Stein, L., Silvestry, S., Zimpfer, D., Wiedemann, D., Goldstein, D., Soltesz, E., Bermudez, C., Haft, J., Patel, B., Moreno, P., MacLaren, G., Tonna, J., Takayama, H., , Lamarche, Y., et al. (2025). EACTS Expert Consensus Document on protected cardiac surgery: pre-emptive use of temporary mechanical circulatory support in adult cardiac surgery patients at high risk for perioperative low cardiac output syndrome. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.
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  Perioperative low cardiac output syndrome (LCOS) remains a significant complication in adult cardiac surgery, contributing to substantial morbidity, prolonged intensive care, and increased mortality. Its incidence is expected to rise further due to the evolving complexity of referred surgical patients, often characterised by advanced age, multiple comorbidities, challenging anatomy, and impaired haemodynamics. Despite advances in pharmacological and perioperative care, outcomes for high-risk patients have not shown significant improvement, prompting interest in temporary mechanical circulatory support (tMCS) as a proactive strategy. This Expert Consensus Document from the European Association for Cardio-Thoracic Surgery (EACTS) presents the first dedicated guidance on the pre-emptive use of tMCS in high-risk adult cardiac surgical patients. Developed by a multidisciplinary task force, it emphasises structured risk stratification, early initiation, and individualised device management informed by interdisciplinary Heart Team discussions. The document proposes clinical pathways for patient selection, defines criteria for tMCS initiation, and provides practical algorithms for various scenarios, including advanced heart failure, cardiogenic shock, and post-cardiotomy LCOS. It reviews the current evidence on available tMCS devices, such as intra-aortic balloon pumps, microaxial flow pumps, veno-arterial extracorporeal life support and hybrid strategies, and addresses perioperative care, ICU protocols, ethical considerations, as well as informed consent and support withdrawal. Despite promising results, substantial knowledge gaps remain, including long-term outcome data, device selection criteria, and cost-effectiveness analyses. This consensus aims to support clinical decision-making, standardise practice, and stimulate research to improve outcomes in a growing population of high-risk surgical patients.
• Nayak, A., Cascino, T. M., DeFilippis, E. M., Hanff, T. C., Cevasco, M., Keenan, J., Zhen-Yu Tong, M., Kilic, A., Koehl, D., Cantor, R., Jacobs, J. P., Habib, R. H., Kirklin, J. K., Cowger, J. A., Pagani, F. D., & Silvestry, S. C. (2026). The Society of Thoracic Surgeons Intermacs 2025 Annual Report: Focus on Outcomes in Older Adults. The Annals of thoracic surgery, 121(1), 15-38.
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  The 16th Annual Report from the Society of Thoracic Surgeons (STS) Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) includes 28,029 continuous-flow left ventricular assist devices (CF LVADs) implanted from 2015 to 2024. Survival remains excellent with the fully magnetically levitated CF LVAD (1-year survival: 85.9%, 5-year survival: 60.2%, 7-year survival: 51.8%). Patients also experience a low incidence of adverse events, including freedom from gastrointestinal bleeding (73.5%), device malfunction (81.8%), and stroke (87.1%) at 5 years, reinforcing the effectiveness of contemporary device platforms. However, despite these advancements, national durable LVAD implant volumes have remained stagnant. A focus on the subgroup of patients aged ≥65 years demonstrates excellent outcomes with respect to survival (1-year survival: 80.6%, 5-year survival: 51.1%), quality of life measures, and adverse events. Survival outcomes in this cohort are robust across a wide spectrum of clinical scenarios, including variation in acuity of illness, temporary mechanical circulatory support use, and psychosocial risk factors, historically associated with worse outcomes. Several clinical inferences may be drawn from these data. First, the increasingly elusive clinical equipoise between heart transplant listing vs a strategy of durable LVAD support merits an individualized and value-based approach to therapy in transplant-eligible older adults. Second, the prospect of 5-year survival exceeding 50%-even in septuagenarians-is a call to action to revise patient eligibility criteria, close the implementation gap, and realize the full potential of this life-saving therapy.
• Potapov, E. V., Whitman, G., John, R., Lanmüller, P., Tucanova, Z., Arora, R. C., Atluri, P., de Waal, E. E., Faerber, G., Loforte, A., Lorusso, R., Morales, D. L., Netuka, I., Pagani, F. D., Gollmann-Tepeköylü, C., Shaffer, A., Silvestry, S. C., Stein, L. H., Takayama, H., , Tsui, S. S., et al. (2025). EACTS/STS/AATS Guidelines on temporary mechanical circulatory support in adult cardiac surgery. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.
• Potapov, E. V., Whitman, G., John, R., Lanmüller, P., Tucanova, Z., Arora, R. C., Atluri, P., de Waal, E. E., Faerber, G., Loforte, A., Lorusso, R., Morales, D. L., Netuka, I., Pagani, F. D., Gollmann-Tepeköylü, C., Shaffer, A., Silvestry, S. C., Stein, L. H., Takayama, H., , Tsui, S. S., et al. (2025). EACTS/STS/AATS Guidelines on temporary mechanical circulatory support in adult cardiac surgery. The Journal of thoracic and cardiovascular surgery.
• Silvestry, S. C. (2025). The next frontier-realizing the promise of DCD heart transplantation. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.
• Silvestry, S. C. (2025). What we know we do not know: The Johari window in DCD heart transplantation. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 44(5), 748-749.
• Silvestry, S. C. (2025). When the Data Changes, So Should We: Rethinking Aspirin in the Modern LVAD Era. JACC. Heart failure, 13(7), 102494.
• Silvestry, S., Meyer, D. M., Pham, S. M., Jacobs, J. P., Shudo, Y., Schroder, J., Leacche, M., Sciortino, C. M., Rodrigo, M. E., Takeda, K., Couper, G., Kawabori, M., Mahesh, B., Klein, L., Vidic, A., Patel, S. R., Loyaga-Rendon, R., Urban, M., & D'Alessandro, D. A. (2025). Improved 2-year heart transplant survival with moderate hypothermic donor heart preservation in the GUARDIAN heart registry. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.
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  Multiple advanced preservation technologies are now available and have demonstrated utility in organ assessment and preservation. The Paragonix SherpaPak Cardiac Transport System (SCTS) has become the most common method of static preservation, demonstrating superior outcomes to historic ice storage. To date, no preservation method has reported improved post-transplant survival.
• Spelde, A. E., Barron, L. M., Cangut, B., Hickey, G. W., Lorusso, R., Silvestry, S. C., Tong, M. Z., Engelman, D. T., Shaw, A. D., Chatterjee, S., & , P. Q. (2025). Escalation and De-escalation of Temporary Mechanical Circulatory Support: Joint Consensus Report of the PeriOperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society. The Annals of thoracic surgery, 120(2), 213-224.
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  Temporary mechanical circulatory support (tMCS) for cardiogenic shock (CS) is increasing despite knowledge gaps and variations in management practices. This document was created to provide clinicians with guidance regarding initiation, escalation, and de-escalation of tMCS in patients with CS.
• D'Alessandro, D., Schroder, J., Meyer, D. M., Vidic, A., Shudo, Y., Silvestry, S., Leacche, M., Sciortino, C. M., Rodrigo, M. E., Pham, S. M., Copeland, H., Jacobs, J. P., Kawabori, M., Takeda, K., & Zuckermann, A. (2024). Impact of controlled hypothermic preservation on outcomes following heart transplantation. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 43(7), 1153-1161.
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  Severe primary graft dysfunction (PGD) is a major cause of early mortality after heart transplant, but the impact of donor organ preservation conditions on severity of PGD and survival has not been well characterized.
• Gosev, I., Pham, D. T., Um, J. Y., Anyanwu, A. C., Itoh, A., Kotkar, K., Takeda, K., Naka, Y., Peltz, M., Silvestry, S. C., Couper, G., Leacche, M., Rao, V., Sun, B., Tedford, R. J., Mokadam, N., McNutt, R., Crandall, D., Mehra, M. R., & Salerno, C. T. (2024). Ventricular assist device using a thoracotomy-based implant technique: Multi-Center Implantation of the HeartMate 3 in Subjects With Heart Failure Using Surgical Techniques Other Than Full Median Sternotomy (HM3 SWIFT). The Journal of thoracic and cardiovascular surgery, 168(5), 1474-1484.e12.
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  The HeartMate 3 (Abbott) left ventricular assist device provides substantial improvement in long-term morbidity and mortality in patients with advanced heart failure. The Implantation of the HeartMate 3 in Subjects With Heart Failure Using Surgical Techniques Other Than Full Median Sternotomy study compares thoracotomy-based implantation clinical outcomes with standard median sternotomy.
• Guglin, M., Hirsch, J. R., Tanawuttiwat, T., Akhtar, N., Silvestry, S., Ilonze, O. J., Gehring, R. M., & Birks, E. J. (2024). How to diagnose and manage emergency medical conditions in patients on left ventricular assist device support: A clinician's field guide. Trends in cardiovascular medicine.
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  Left ventricular assist devices (LVADs) have revolutionized the treatment of advanced heart failure, providing mechanical circulatory support for patients awaiting heart transplantation or as destination therapy. However, patients on LVAD support are susceptible to a range of emergency medical conditions that require prompt recognition, intervention, and multidisciplinary management. This review paper aims to provide an algorithmic approach and a field guide on the diagnosis and management of emergency medical conditions in LVAD patients, including LVAD alarms, gastrointestinal bleeding, cerebrovascular accidents, pump thrombosis and obstruction, unresponsiveness, and electrical shock by the defibrillator. By understanding the mechanisms, clinical presentation, diagnostic evaluation, and therapeutic strategies associated with these conditions, healthcare providers can improve patient outcomes and optimize LVAD care.
• Hoffman, J. R., Hartwig, M. G., Cain, M. T., Rove, J. Y., Siddique, A., Urban, M., Mulligan, M. S., Bush, E. L., Balsara, K., Demarest, C. T., Silvestry, S. C., Wilkey, B., Trahanas, J. M., Pretorius, V. G., Shah, A. S., Moazami, N., Pomfret, E. A., Catarino, P. A., & , I. c. (2024). Consensus Statement: Technical Standards for Thoracoabdominal Normothermic Regional Perfusion. Transplantation, 108(8), 1669-1680.
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  Thoracoabdominal normothermic regional perfusion (TA-NRP) has emerged as a powerful technique for optimizing organ procurement from donation after circulatory death donors. Despite its rapid adoption, standardized guidelines for TA-NRP implementation are lacking, prompting the need for consensus recommendations to ensure safe and effective utilization of this technique.
• Hoffman, J. R., Hartwig, M. G., Cain, M. T., Rove, J. Y., Siddique, A., Urban, M., Mulligan, M. S., Bush, E. L., Balsara, K., Demarest, C. T., Silvestry, S. C., Wilkey, B., Trahanas, J. M., Pretorius, V. G., Shah, A. S., Moazami, N., Pomfret, E. A., Catarino, P. A., , A. S., , , I. S., et al. (2024). Consensus Statement: Technical Standards for Thoracoabdominal Normothermic Regional Perfusion. The Annals of thoracic surgery, 118(4), 778-791.
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  Thoracoabdominal normothermic regional perfusion (TA-NRP) has emerged as a powerful technique for optimizing organ procurement from donation after circulatory death donors. Despite its rapid adoption, standardized guidelines for TA-NRP implementation are lacking, prompting the need for consensus recommendations to ensure safe and effective utilization of this technique.
• Hong, Y., Couper, C. D., Iyanna, N., Hess, N. R., Ziegler, L. A., Abdullah, M., Mathier, M. A., Hickey, G. W., Keebler, M. E., Silvestry, S. C., & Kaczorowski, D. (2024). Mid-term Waitlist and Posttransplant Outcomes With Hepatitis C-positive Donor Hearts. Transplantation.
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  This study evaluates the clinical trends and impact of hepatitis C virus-positive (HCV+) donors on waitlist and posttransplant outcomes after heart transplantation.
• Kwon, J. H., Bentley, D., Cevasco, M., Blumer, V., Kanwar, M. K., Silvestry, S. C., Daneshmand, M. A., Abraham, J., Shorbaji, K., & Kilic, A. (2024). Patient Characteristics and Early Clinical Outcomes With Impella 5.5: A Systematic Review and Meta-Analysis. ASAIO journal (American Society for Artificial Internal Organs : 1992), 70(7), 557-564.
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  Data regarding outcomes with Impella 5.5 are limited. The aim of this systematic review and meta-analysis was to summarize patient and treatment characteristics and early clinical outcomes among patients supported by Impella 5.5. A systematic literature search was conducted in PubMed, Scopus, and Cochrane databases from September 2019 to March 2023. Studies reporting outcomes in greater than or equal to 5 patients were included for review. Patient characteristics, treatment characteristics, and early clinical outcomes were extracted. Outcomes included adverse events, survival to hospital discharge, and 30 day survival. Random-effect models were used to estimate pooled effects for survival outcomes. Assessment for bias was performed using funnel plots and Egger's tests. Fifteen studies were included for qualitative review, representing 707 patients. Mean duration of support was 9.9 ± 8.2 days. On meta-analysis of 13 studies reporting survival outcomes, survival to hospital discharge was 68% (95% confidence interval [CI], 58-78%), and 30 day survival was 65% (95% CI, 56-74%) among patients with Impella devices predominantly supported by Impella 5.5 (>60%). There was significant study heterogeneity for these outcomes. Among 294 patients with Impella 5.5 only, survival to discharge was 78% (95% CI, 72-82%) with no significant study heterogeneity. This data present early benchmarks for outcomes with Impella 5.5 as clinical experience with these devices accrues.
• Lerman, J. B., Patel, C. B., Casalinova, S., Nicoara, A., Holley, C. L., Leacche, M., Silvestry, S., Zuckermann, A., D'Alessandro, D. A., Milano, C. A., Schroder, J. N., & DeVore, A. D. (2024). Early Outcomes in Patients With LVAD Undergoing Heart Transplant via Use of the SherpaPak Cardiac Transport System. Circulation. Heart failure, 17(5), e010904.
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  Heart transplant (HT) in recipients with left ventricular assist devices (LVADs) is associated with poor early post-HT outcomes, including primary graft dysfunction (PGD). As complicated heart explants in recipients with LVADs may produce longer ischemic times, innovations in donor heart preservation may yield improved post-HT outcomes. The SherpaPak Cardiac Transport System is an organ preservation technology that maintains donor heart temperatures between 4 °C and 8 °C, which may minimize ischemic and cold-induced graft injuries. This analysis sought to identify whether the use of SherpaPak versus traditional cold storage was associated with differential outcomes among patients with durable LVAD undergoing HT.
• Moayedifar, R., Shudo, Y., Kawabori, M., Silvestry, S., Schroder, J., Meyer, D. M., Jacobs, J. P., D'Alessandro, D., & Zuckermann, A. (2024). Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 43(4), 673-680.
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  The prevalence of end-stage heart failure and patients who could benefit from heart transplantation requires an expansion of the donor pool, relying on the transplant community to continually re-evaluate and expand the use of extended criteria donor organs. Introduction of new technologies such as the Paragonix SherpaPak Cardiac Transport System aids in this shift. We seek to analyze the impact of the SherpaPak system on recipient outcomes who receive extended criteria organs in the GUARDIAN-Heart Registry.
• Nickel, I., Potapov, E., Sun, B., Zimpfer, D., Koliopoulou, A., Adachi, I., Anyanwu, A., Falk, V., Atluri, P., Faerber, G., Goldstein, D., Yarboro, L., Slaughter, M. S., Milano, C., Tsukashita, M., D'Alessandro, D., Silvestry, S., Kirov, H., Bommareddi, S., , Lanmüller, P., et al. (2024). Deactivation of LVAD support for myocardial recovery-surgical perspectives. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 43(9), 1489-1500.
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  Left ventricular assist devices (LVADs) are excellent therapies for advanced heart failure patients either bridged to transplant or for lifetime use. LVADs also allow for reverse remodeling of the failing heart that is often associated with functional improvement. Indeed, growing enthusiasm exists to better understand this population of patients, whereby the LVAD is used as an adjunct to mediate myocardial recovery. When patients achieve benchmarks suggesting that they no longer need LVAD support, questions related to the discontinuation of LVAD therapy become front and center. The purpose of this review is to provide a surgical perspective on the practical and technical issues surrounding LVAD deactivation.
• Schroder, J. N., Patel, C. B., DeVore, A. D., Casalinova, S., Koomalsingh, K. J., Shah, A. S., Anyanwu, A. C., D'Alessandro, D. A., Mudy, K., Sun, B., Strueber, M., Khaghani, A., Shudo, Y., Esmailian, F., Liao, K., Pagani, F. D., Silvestry, S., Wang, I. W., Salerno, C. T., , Absi, T. S., et al. (2024). Increasing Utilization of Extended Criteria Donor Hearts for Transplantation: The OCS Heart EXPAND Trial. JACC. Heart failure, 12(3), 438-447.
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  Extended criteria donor (ECD) hearts available with donation after brain death (DBD) are underutilized for transplantation due to limitations of cold storage.
• Silvestry, S. (2024). Discussion. The Journal of thoracic and cardiovascular surgery, 167(5), 1819-1820.
• Silvestry, S. C. (2024).

  Improved 2-Year Heart Transplant Survival with Moderate Hypothermic Donor Heart Preservation in the Guardian Heart Registry

  . Journal of Heart and Lung Transplantation. doi:10.1016/j.healun.2024.02.139
• Silvestry, S. C. (2024).

  Risk of RV Dysfunction Following Heart Transplantation: Donor Organ Temperature Matters!

  . Journal of Cardiac Failure.
• Silvestry, S. C. (2024). Commentary: Left ventricular assist device complications after heart transplantation: Then and now. The Journal of thoracic and cardiovascular surgery, 167(3), 1061-1063.
• Silvestry, S. C. (2024). Commentary: The evolving market of heart transplantation. The Journal of thoracic and cardiovascular surgery, 167(5), 1864-1865.
• Silvestry, S. C. (2024). Commentary: The search for left ventricular assist device outflow tract obstruction. The Journal of thoracic and cardiovascular surgery, 167(4), 1331-1332.
• Silvestry, S. C. (2024). Commentary: Tricuspid repair and left ventricular assist device: A new baseline. The Journal of thoracic and cardiovascular surgery, 167(5), 1821-1822.
• Silvestry, S. C. (2024). Doctor, Your Patient is the Neighborhood. Annals of surgery, 279(3), 383-384.
• Silvestry, S., Leacche, M., Meyer, D. M., Shudo, Y., Kawabori, M., Mahesh, B., Zuckermann, A., D'Alessandro, D., & Schroder, J. (2024). Outcomes in Heart Transplant Recipients by Bridge to Transplant Strategy When Using the SherpaPak Cardiac Transport System. ASAIO journal (American Society for Artificial Internal Organs : 1992), 70(5), 388-395.
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  The last several years have seen a rise in use of mechanical circulatory support (MCS) to bridge heart transplant recipients. A controlled hypothermic organ preservation system, the SherpaPak Cardiac Transport System (SCTS), was introduced in 2018 and has grown in utilization with reports of improved posttransplant outcomes. The Global Utilization And Registry Database for Improved heArt preservatioN (GUARDIAN)-Heart registry is an international, multicenter registry assessing outcomes after transplant using the SCTS. This analysis examines outcomes in recipients bridged with various MCS devices in the GUARDIAN-Heart Registry. A total of 422 recipients with donor hearts transported using SCTS were included and identified. Durable ventricular assist devices (VADs) were used exclusively in 179 recipients, temporary VADs or intra-aortic balloon pump (IABP) in 197, and extracorporeal membrane oxygenation (ECMO) in 14 recipients. Average ischemic times were over 3.5 hours in all cohorts. Severe primary graft dysfunction (PGD) posttransplant increased across groups (4.5% VAD, 5.1% temporary support, 21.4% ECMO), whereas intensive care unit (ICU) length of stay (18.2 days) and total hospital stay (39.4 days) was longer in the ECMO cohort than the VAD and IABP groups. A comparison of outcomes of MCS bridging in SCTS versus traditional ice revealed significantly lower rates of both moderate/severe right ventricular (RV) dysfunction and severe PGD in the SCTS cohort; however, upon propensity matching only the reductions in moderate/severe RV dysfunction were statistically significant. Use of SCTS in transplant recipients with various bridging strategies results in excellent outcomes.

Presentations

• Silvestry, S. C. (2025, Feb).

  Cardiogenic Shock|HRPCI – Panelist
  Cardiogenic Shock: When to Call a Surgeon

  . CVIS 2025 Summit. Tucson, AZ.
• Silvestry, S. C. (2025, Feb).

  Heart Transplantation II: Advances in Organ Preservation and DCD – Moderator

  . North America Users Summit. Boston, MA: J&J Med Tech/Abiomed.
• Silvestry, S. C. (2025, Feb).

  Presentation and Discussion of Use of Impella 5.5 in Surgery, and Escalation in Shock. To Include Patient Selection, Interoperative Technique, Troubleshooting and Weaning

  . J&J Med Tech/Abiomed.
• Silvestry, S. C. (2025, June).

  Enhancing Surgical Outcomes in Cardiogenic Shock

  . J&J Med Tech/Abiomed.
• Silvestry, S. C. (2025, June).

  Tailored Approached to Patient Management and Escalation 

  . Jefferson Presentation. Philadelphia, PA: J&J Med Tech/Abiomed.
• Silvestry, S. C. (2025, Mar).

  The 13th Annual Critical Care and Cardiac Surgery Lecture in Honor of Mrs. Lynne Van Praag

  . Johns Hopkins Medicine Grand Rounds. Baltimore, MD.
• Silvestry, S. C. (2025, Mar).

  Treatment or Cardiogenic Shock and Escalation Strategies with Impella 5.5

  . J&J Med Tech/Abiomed. Cincinnati, OH.
• Silvestry, S. C. (2025, May).

  Impella 5.5 Support for Heart Failure-related CS and 1-year Survival – SURPASS Registry
  Shock and Surgery & Axillary Insertion

  . Advanced Surgical Heart Failure Course. San Francisco, CA.
• Silvestry, S. C. (2025, Oct).

  Laman A. Gray Lecture

  . Annual Lecture in Conjunction with Department of Surgery Grand Rounds. Louisville, KY: University of Louisville.
• Silvestry, S. C. (2025, Sept).

  DCD Selection – Which Donor to Send the Team
      Options for Organ Procurement – Outsourcing?

  . Brano Conference. Spain.
• Silvestry, S. C. (2025, Sept).

  What Device and When for Post Cardiotomy Shock

  . ELSO Conference. Oxen Hill, MD: ELSO.
• Silvestry, S. C. (2024, May). Quo Vadis Mechanical Circulatory Support?. HVI Grand RoundsPenn State College of Medicine.