Scott D Lick
- Professor, Surgery
- Professor, Surgery
- M.D. medicine - surgery
- University of Minnesota School of Medicine, Minneapolis, Minnesota, United States
- B.S. Biology -Magna Cum Laude
- Creighton University, Omaha, United States
- College of Medicine, University of Arizona, Tucson, Arizona (2014 - Ongoing)
- UTMB (2010 - 2014)
- UTMB (1999 - 2010)
- UTMB (1994 - 2014)
- UTMB (1994 - 1999)
- University of Arizona, Tucson, Arizona (1992 - 1994)
- University of Arizona, Tucson, Arizona (1987 - 1992)
- Best Doctors in America - National List 1999
- Spring 1999
- Best Doctors in America - Central Region 1996-7
- Spring 1996
- Ernie Hodge Lecturer
- Texas Transplant Society annual meeting, 2009, Winter 2009
- Texas Super Doctors list
- Texas Monthly, Spring 2004
Licensure & Certification
- Texas Medical License, Texas Board of Medical Examiners (1994)
- Minnesota License, Minnesota Board of Medical Examiners (2009)
- Arizona License, Arizona Board of Medical Examiners (1989)
- Board Certification, American Board of Thoracic Surgery (1995)
- Board Certification, American Board of Surgery (1993)
No activities entered.
INDSURG 837B (Spring 2019)
INDSURG 837B (Spring 2018)
INDSURG 837B (Fall 2017)
INDSURG 837B (Spring 2017)
INDSURG 848B (Spring 2017)
INDSURG 837B (Fall 2016)
- Lick, S. D., Copeland, J. G., & Smith, R. (1995). Valves in Pulsatile Devices. In Mechanical Circulatory Support. London: Edward Arnold.
- Lick, S. D., Copeland, J. G., Smith, R., & Cleavinger, M. (1993). The Symbion Acute Ventricular Assist Device (AVAD). In Cardiac Surgery: State of the Art Reviews(pp 327-34). Philadelphia: Hanley and Belfus.More infoThe University of Arizona Experience, in Ott, Gutfinger and Gazaniga (eds)
- Cosgrove, R. H., Basken, R. L., Smith, R. G., Hsu, C. H., Kazui, T., Martinez, B. K., Burt, R. W., Crawford, E. S., Lick, S. D., & Khalpey, Z. (2018). Anticoagulant Bridge Comparison in Mechanical Circulatory Support Patients. ASAIO journal (American Society for Artificial Internal Organs : 1992).More infoMaintaining mechanical circulatory support (MCS) device patients in a specified therapeutic range for anticoagulation remains challenging. Subtherapeutic international normalized ratios (INRs) occur frequently while on warfarin therapy. An effective anticoagulant bridge strategy may improve the care of these patients. This retrospective review of MCS patients with subtherapeutic INRs compared an intravenous unfractionated heparin (UFH) strategy with a subcutaneous enoxaparin or fondaparinux strategy. Native thromboelastography (n-TEG) was used to evaluate anticoagulant effect with coagulation index (CI) as the primary outcome measure. Enoxaparin 0.5 mg/kg SC q12hrs or fondaparinux 2.5-5 mg SC daily were compared with an initial UFH rate of 5 units/kg/hr and titrated to stated n-TEG goal range. The anticoagulant groups UFH, enoxaparin, and fondaparinux were found to be statistically similar with regard to frequency in n-TEG goal range, above range (hypercoagulability), or below range (hypocoagulability). Clinical outcomes were similar among groups with three gastrointestinal bleeds in UFH, one in enoxaparin, and one in fondaparinux groups. Device thrombosis occurred in one UFH patient, while UFH and fondaparinux groups had one ischemic cerebrovascular accident event each. These strategies provided comparable n-TEG results and clinical outcomes when compared with intravenous UFH. Low-dose enoxaparin or fondaparinux may provide an alternative anticoagulant bridging option in MCS patients presenting with subtherapeutic INR.
- Kazui, T., Lin, T. M., & Lick, S. D. (2018). Coronary Sinus Rupture Repair: Patency Is Important. The Annals of thoracic surgery.More infoWe report a case of coronary sinus (CS) injury with a retrograde cardioplegia catheter and repair compromising CS patency. This resulted in acute global cardiac dysfunction shortly after weaning from bypass, which reversed after patch repair with confirmed CS patency. The case shows that acute CS occlusion may not be tolerated in some humans.
- Lick, S. D., Tasset, M., Baker, Z., Pantino, D., & Amabile, O. (2018). Sternotomy extra-anatomic bypass followed by stent-graft extraction. The Journal of thoracic and cardiovascular surgery, 155(3), 912-913.
- Avery, R., Paidy, S. R., Keller, R., Lick, S., Smith, R. G., & Khalpey, Z. (2017). Tissue Expander as a Routine Component of 50cc Total Artificial Heart Implantation for Bridge to Transplant. Circulation. Heart failure, 10(1), e003765.
- Ferng, A., Connell, A., Nunez, M., Johnson, K., Braunhut, B., Lick, S., Desai, A., Kazui, T., Runyan, R., & Khalpey, Z. (2017). Cardiac Regeneration in the Human Left Ventricle After CorMatrix Implantation. The Annals of thoracic surgery, 104(3), e239-e241.More infoCorMatrix is an organic extracellular matrix (ECM) derived from porcine small intestine submucosa and is used for pericardial closure and cardiac tissue repair. During explantation of a HeartMate II (Thoratec Corp, Pleasanton, CA) left ventricular assist device (LVAD) because of infection, CorMatrix was used to repair the left ventricular apex and aorta. Three months later, a HeartWare HVAD (HeartWare International, Inc, Framingham, MA) was implanted for recurrent heart failure. Excised apical CorMatrix samples showed cardiac tissue remodeling with viable cardiomyoblasts similar to native myocardium. Excised CorMatrix from the aorta showed organization of collagen and elastin similar to native aortic tissue.
- Khalpey, Z. I., Badi, R., Kazui, T., & Lick, S. D. (2017). Bileaflet foldoplasty in Barlows disease. J Heart Valve Dis, 26(3), 355-357.
- Nielsen, V. G., Paidy, S. R., Meek, C. A., Thornton, T. K., & Lick, S. D. (2017). Survival after intravenous thrombin prior to cardiopulmonary bypass. International journal of legal medicine, 131(2), 485-487.More infoWe present a case of a patient undergoing aortic valve replacement being inadvertently administered 5000 U of bovine thrombin instead of heparin for anticoagulation for cardiopulmonary bypass. The labeling error was made within the operating room pharmacy. The key to survival of this patient was a rapid diagnosis, administration of antithrombin and heparin, and removal of cardiac and great vessel thrombi. It is recommended that point of care anesthesia providers `prepare heparin for cardiopulmonary bypass anticoagulation, as thrombin is not used in anesthetic practice and is not contained within anesthesia cabinet medication drawers.
- Schipper, D. A., Palsma, R., Marsh, K. M., O'Hare, C., Dicken, D. S., Lick, S., Kazui, T., Johnson, K., Smolenski, R. T., Duncker, D. J., & Khalpey, Z. (2017). Chronic Myocardial Ischemia Leads to Loss of Maximal Oxygen Consumption and Complex I Dysfunction. The Annals of thoracic surgery, 104(4), 1298-1304.More infoCardiomyocytes rely heavily on mitochondrial energy production through oxidative phosphorylation. Chronic myocardial ischemia may cause mitochondrial dysfunction and affect ATP formation. Metabolic changes due to ischemia alters cardiac bioenergetics and hence myocardial function and overall bioenergetic state. Here, we evaluate differences in functional status of respiratory complexes in mitochondrial isolates extracted from left atrial appendage tissue (LAA) from patients undergoing cardiac surgery, with and without chronic ischemia.
- Eksinar, S., Gedevanishvili, A., Koroglu, M., Afzal, A., Oto, A., Conti, V., Lick, S. D., & Bungo, M. W. (2016). Extrinsic compression of the left main coronary artery in pulmonary hypertension. JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR), 88(4), 190-2.More infoCompression of the left main coronary artery by a dilated pulmonary artery can be a life-threatening condition. It can present with angina, symptoms of left ventricular dysfunction, and sudden death. Diagnosis and treatment of this condition is very important. We demonstrate significant compression of the left main coronary artery on coronary angiography and thorax CT examinations.
- Harper, D. D., Alpard, S. K., Deyo, D. J., Lick, S. D., Traber, D. L., & Zwischenberger, J. B. (2016). Anatomic study of the pulmonary artery as a conduit for an artificial lung. ASAIO journal (American Society for Artificial Internal Organs : 1992), 47(1), 34-6.More infoOur group is developing an artificial lung as a bridge to transplant. We evaluated the sheep pulmonary artery (PA) for the presence or absence of a septum, which may increase PA resistance and affect artificial lung flow. We also measured the PA size to determine whether it is a suitable conduit for artificial lung implantation using a PA-PA shunt. Adult Suffolk ewes in two groups were studied. Group 1 consisted of animals (n = 12, 30-43 kg) prepared for thoracotomy. Group 2 (n = 21, 30-43 kg) consisted of postmortem dissections. In both groups, the length and girth of the PA was measured. The heart and lungs were removed on all postmortem animals (group 2), the ductus arteriosum was crosscut, and the common PA was incised. The average length of the PA in live animals was 5.5 cm and the average diameter was 2.2 cm. The average length of the PA in postmortem animals was 4.8 cm and the average diameter was 2.0 cm. All pulmonary arteries were aseptate, and the ligamentum arteriosum in each PA was not patent. We conclude that the PA is not a source of increased resistance and is a suitable conduit for artificial lung implantation in the PA-PA configuration.
- Kannan, A., Lick, S., Teodori, M. F., Brody, E., & Janardhanan, R. (2016). Giant Pulmonary Artery Aneurysm in a 40-Year-Old Woman after Patent Ductus Arteriosus Ligation at 2 Years of Age. Texas Heart Institute journal, 43(3), 274-6.
- Kazui, T., Nicole, S., Friedman, M., Kim, S. S., Lick, S., & Khalpey, Z. I. (2016). A modified Park's stitch to correct aortic insufficiency for bioprosthetic valve at time of left ventricular assist device implant: a case report.. Journal of Cardiothoracic Surgery, 11(1), 161.
- Khalpey, Z., Kazui, T., Ferng, A. S., Connell, A., Tran, P. L., Meyer, M., Rawashdeh, B., Smith, R. G., Sweitzer, N. K., Friedman, M., Lick, S., Slepian, M. J., & Copeland, J. G. (2016). First North American 50 cc Total Artificial Heart Experience: Conversion from a 70 cc Total Artificial Heart. ASAIO journal (American Society for Artificial Internal Organs : 1992), 62(5), e43-5.More infoThe 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH.
- Lick, S. D. (2016). Analysis of pulmonary non-tuberculous mycobacterial infections after lung transplantation. Transplant Infectious Disease.
- Lick, S. D., & Zwischenberger, J. B. (2016). Artificial lung: bench toward bedside. ASAIO journal (American Society for Artificial Internal Organs : 1992), 50(1), 2-5.
- Lick, S. D., Deyo, D. J., Wang, D., Witt, S. A., Alpard, S. K., Harper, D. D., & Zwischenberger, J. B. (2016). Paracorporeal artificial lung: perioperative management for survival study in sheep. Journal of investigative surgery : the official journal of the Academy of Surgical Research, 16(3), 177-84.More infoAn artificial lung may offer a bridge to recovery or transplant. Utilizing our recently developed paracorporeal artificial lung (PAL) in survival studies in sheep, we critically review our perioperative/anesthetic protocol. Adult Suffolk ewes (n = 15) underwent general anesthesia induced by ketamine (7-15 mg/kg, im) and isoflurane by mask, then intubated and maintained by 4.0-5.0% isoflurane titrated to mean arterial pressure (MAP) 70-110 mm Hg. After a latissimus-sparing thoracotomy and systemic heparinization (200 IU/kg), arterial grafts were anastomosed to the proximal and distal main pulmonary artery in an end-of-graft to side-of-artery fashion. A snare was passed around the pulmonary artery between anastomoses. When the snare was tightened, full pulmonary blood flow was diverted through the cannulae and immediately through the PAL. Perioperative crystalloids included a 500-mL prime, lactated Ringer's (LR) titrated to CVP 5-7 mm Hg, and a heparin infusion (activated clotting time [ACT] 250-300 s). Buprenorphine (0.3 mg im tid) controlled postoperative pain. Hemodynamic parameters, arterial blood gases (ABGs), and ACTs were measured every 6 h. Thirteen of 15 sheep survived the operation and were extubated in less than 20 min. Two groups were studied for up to 7-day survival. Both groups underwent immediate connection to the PAL diverting full pulmonary blood flow. Group 1 (n = 8) underwent immediate connection to a rigidly housed PAL, and 4 of 8 demonstrated immediate right heart failure. In Group 2 a compliance chamber was added to the PAL inflow, and 6 of 7 had stable hemodynamic function for the duration of the study. Incremental improvements in the PAL and our anesthetic and perioperative care have resulted in reliable survival in adult sheep allowing for artificial lung development.
- Lick, S. D., Tran, P. L., Kazui, T., Smith, R. G., & Khalpey, Z. I. (2016). Total Artificial Heart, Augmented by Veno-Venous Extracorporeal Membrane Oxygenation. ASAIO journal (American Society for Artificial Internal Organs : 1992).More infoShortly after SynCardia Total Artificial Heart (TAH) implant, veno-venous extra-corporeal membrane oxygenation (ECMO) via a 31-French Avalon cannula was used for profound hypoxic lung dysfunction. Immediately after starting ECMO, TAH flow increased by 1.5-2.0 liters/minute, presumably due to augmented TAH filling by the ECMO jet.
- Lick, S. D., Zwischenberger, J. B., Alpard, S. K., Witt, S. A., Deyo, D. M., & Merz, S. I. (2016). Development of an ambulatory artificial lung in an ovine survival model. ASAIO journal (American Society for Artificial Internal Organs : 1992), 47(5), 486-91.More infoWe are developing an artificial lung (AL) as an eventual bridge to lung transplant or recovery. The device is rigidly housed, noncompliant, and has a very low resistance to blood flow. In eight sheep, arterial cannulae were anastomosed end-to-side to the proximal and distal main pulmonary artery, and attached to the AL. A pulmonary artery snare between anastomoses diverted full pulmonary blood flow through the AL. Eight of eight sheep survived the preparation. Mean pressure gradient across the AL was 8 mm Hg (3 Wood units; 8 mm Hg/2.8 L/min). Four of eight sheep tolerated immediate full diversion of blood flow and died at 24 and 40 hours (exsanguination) or 168 and 168 hours (elective sacrifice). Four of eight sheep were intolerant of full flow: two died of right heart failure at
- Lick, S., & Meyer, D. (2016). A little extra cushion. ASAIO journal (American Society for Artificial Internal Organs : 1992), 58(4), 295.
- Shetty, S., Hamoud, N., O'Farrell, K., Lick, S., & Janardhanan, R. (2016). 'Loud Continuous Murmur' After Aortic Surgery: A Clue to an Aortic Root to Right Ventricular Outflow Tract Fistula. The American journal of medicine, 129(11), e287-e288.
- Tran, P. L., Kazui, T., Perovic, V., Mikail, P., Lick, S., Smith, R., Betterton, E. W., Venkat, R., Iwanski, J., Wong, R. K., Slepian, M. J., & Khalpey, Z. (2016). Case report: disparate flow in HeartMate II patient with extensive left ventricle repair. Perfusion, 31(4), 349-52.
- Zwischenberger, J. B., Anderson, C. M., Cook, K. E., Lick, S. D., Mockros, L. F., & Bartlett, R. H. (2016). Development of an implantable artificial lung: challenges and progress. ASAIO journal (American Society for Artificial Internal Organs : 1992), 47(4), 316-20.More infoUnlike dialysis, which functions as a bridge to renal transplantation, or a ventricular assist device, which serves as a bridge to cardiac transplantation, no suitable bridge to lung transplantation exists. Our goal is to design and build an ambulatory artificial lung that can be perfused entirely by the right ventricle and completely support the metabolic O2 and CO2 requirements of an adult. Such a device could realize a substantial clinical impact as a bridge to lung transplantation, as a support device immediately post-lung transplant, and as a rescue and/or supplement to mechanical ventilation during the treatment of severe respiratory failure. Research on the artificial lung has focused on the design, mode of attachment to the pulmonary circulation, and intracorporeal versus paracorporeal placement of the device.
- Khalpey, Z., Kazui, T., Ferng, A. S., Connell, A., Tran, P. L., Meyer, M., Rawashdeh, B., Smith, R. G., Sweitzer, N. K., Friedman, M., Lick, S., Slepian, M. J., & Copeland, J. G. (2015). First North American 50 cc Total Artificial Heart Experience: Conversion from a 70 cc Total Artificial Heart. ASAIO journal (American Society for Artificial Internal Organs : 1992), 62(5), e43-5.More infoThe 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH.
- Lick, S., & Meyer, D. (2015). A little extra cushion. ASAIO journal (American Society for Artificial Internal Organs : 1992), 58(4), 295.
- Tran, P. L., Kazui, T., Perovic, V., Mikail, P., Lick, S., Smith, R., Betterton, E. W., Venkat, R., Iwanski, J., Wong, R. K., Slepian, M. J., & Khalpey, Z. (2015). Case Report: Disparate flow in HeartMate II patient with extensive left ventricle repair. Perfusion.More infoThis case study reports the operative management of a 63-year-old male patient following implantation of the HeartMate II (HMII) left ventricular assist device (LVAD), with a non-compliant left ventricle (LV) and a reduced right ventricular (RV) end-diastolic volume. Intraoperatively, the patient had a thin, fragile LV wall with laminated clot; a ventricular septal defect was encountered during removal of the clot. Along with an aortic valve repair, the LV and the septum were reconstructed with multiple bovine pericardium patches, thus, moderately reducing the RV and LV stroke volume. A difference in cardiac output via a Swan-Ganz catheter (approximately 1.5 l/min) was observed as opposed to the HMII's estimated flow. The result was later replicated and verified in vitro via the Donovan Mock Circulation System (DMCS), where about 2 l/min lower flow on the HMII system was observed. In conclusion, the HMII flow rate displayed can be inaccurate and should only be used for trending.
- Maoz-Metzl, D., Morsy, M., Khalife, W. I., & Lick, S. D. (2014). Park's stitch for a bicuspid aortic valve in a patient on LVAD support. Journal of cardiac surgery, 29(6), 843-5.More infoA central coaptation stitch (Park's stitch) is a simple surgical option in the management of aortic insufficiency in patients with left ventricular assist devices. We describe a 66-year-old male with aortic insufficiency and a bicuspid aortic valve undergoing left ventricular assist device implantation. His aortic insufficiency was successfully addressed with a Park's stitch.
- Lick, S. D., Beckles, D. L., & Conti, V. R. (2013). Partial transplant cardiectomy mitral exposure. The Journal of thoracic and cardiovascular surgery, 145(5), 1413-4.
- Nichols, J. E., Niles, J., Riddle, M., Vargas, G., Schilagard, T., Ma, L., Edward, K., La Francesca, S., Sakamoto, J., Vega, S., Ogadegbe, M., Mlcak, R., Deyo, D., Woodson, L., McQuitty, C., Lick, S., Beckles, D., Melo, E., & Cortiella, J. (2013). Production and assessment of decellularized pig and human lung scaffolds. Tissue engineering. Part A, 19(17-18), 2045-62.More infoThe authors have previously shown that acellular (AC) trachea-lung scaffolds can (1) be produced from natural rat lungs, (2) retain critical components of the extracellular matrix (ECM) such as collagen-1 and elastin, and (3) be used to produce lung tissue after recellularization with murine embryonic stem cells. The aim of this study was to produce large (porcine or human) AC lung scaffolds to determine the feasibility of producing scaffolds with potential clinical applicability. We report here the first attempt to produce AC pig or human trachea-lung scaffold. Using a combination of freezing and sodium dodecyl sulfate washes, pig trachea-lungs and human trachea-lungs were decellularized. Once decellularization was complete we evaluated the structural integrity of the AC lung scaffolds using bronchoscopy, multiphoton microscopy (MPM), assessment of the ECM utilizing immunocytochemistry and evaluation of mechanics through the use of pulmonary function tests (PFTs). Immunocytochemistry indicated that there was loss of collagen type IV and laminin in the AC lung scaffold, but retention of collagen-1, elastin, and fibronectin in some regions. MPM scoring was also used to examine the AC lung scaffold ECM structure and to evaluate the amount of collagen I in normal and AC lung. MPM was used to examine the physical arrangement of collagen-1 and elastin in the pleura, distal lung, lung borders, and trachea or bronchi. MPM and bronchoscopy of trachea and lung tissues showed that no cells or cell debris remained in the AC scaffolds. PFT measurements of the trachea-lungs showed no relevant differences in peak pressure, dynamic or static compliance, and a nonrestricted flow pattern in AC compared to normal lungs. Although there were changes in content of collagen I and elastin this did not affect the mechanics of lung function as evidenced by normal PFT values. When repopulated with a variety of stem or adult cells including human adult primary alveolar epithelial type II cells both pig and human AC scaffolds supported cell attachment and cell viability. Examination of scaffolds produced using a variety of detergents indicated that detergent choice influenced human immune response in terms of T cell activation and chemokine production.
- Lick, S. D., Beckles, D. L., Piovesana, G., Vaidya, S., Indrikovs, A., Barbagelata, N. A., & Valentine, V. (2011). Transplantation of high panel-reactive antibody left ventricular assist device patients without crossmatch using on-bypass pheresis and alemtuzumab. The Annals of thoracic surgery, 92(4), 1428-34.More infoHighly sensitized (HS) left ventricular assist device (LVAD) patients with high panel-reactive antibody (PRA) levels present a challenge. Alemtuzumab, a potent depleting agent for T and B lymphocytes (months to years), and plasmapheresis, offer an opportunity for heart transplantation to these patients who might die of VAD complications on the transplant waiting list. This study compared rates of acute rejection and survival of a HS LVAD cohort with a contemporaneous control group after heart transplant.
- Lick, S. D., Kollar, A. C., & Conti, V. R. (2010). "Snake-jaw" graft for aortic valve exposure during LVAD implant. Journal of cardiac surgery, 25(6), 747-8.More infoWe report a simple technique of LVAD outflow anastomosis as patch closure of a standard aortotomy during left ventricular assist device (LVAD) implant. Benefits are a single aortotomy, a low graft leaving ample native aorta for transplant, a wide-open LVAD outflow, and excellent aortic valve exposure.
- Kollar, A. C., Lick, S. D., & Conti, V. R. (2009). Valve-sparing aortic root reconstruction using in situ three-dimensional measurements. The Annals of thoracic surgery, 87(6), 1795-800.More infoThe truncated cone overall geometry of the native aortic root, an important factor in maintaining valvular competence, is significantly altered in cases of root aneurysms. We hypothesized that an early trial restoration of valve competence within the native aortic root followed by in situ three-dimensional measurements may lead to a more predictable functional reconstruction.
- Lick, S. D., & Kollar, A. (2009). Direct true lumen cannulation in surgery for acute type A aortic dissection is a valuable but risky alternative. The Annals of thoracic surgery, 88(5), 1727; author reply 1727-8.
- Lick, S. D., Kollar, A. C., & Conti, V. R. (2009). Physician certification and implantable cardioverter-defibrillators. JAMA, 302(9), 941; author reply 942-3.
- Duarte, A. G., Terminella, L., Smith, J. T., Myers, A. C., Campbell, G., & Lick, S. (2008). Restoration of cough reflex in lung transplant recipients. Chest, 134(2), 310-6.More infoLung transplantation involves vagal nerve interruption resulting in sensory airway denervation and impairment of the cough reflex. Following lung transplantation, it is unclear whether functional recovery of the cough reflex occurs over time. Our objective was to evaluate the afferent limb of the cough reflex in lung transplant recipients.
- Kollar, A. C., Lick, S. D., & Conti, V. R. (2008). Integrating resuspension with remodeling: early results with a new valve-sparing aortic root reconstruction technique. The Journal of heart valve disease, 17(1), 74-9; discussion 79-80.More infoCurrently, two different valve-sparing aortic root reconstruction methods are utilized, namely reimplantation and remodeling. Herein are reported the authors' early results with a new technique that integrates the two procedures.
- Lick, S. D., Vaidya, S., Kollar, A. C., Boor, P. J., & Vertrees, R. A. (2008). Peri-operative alemtuzumab (Campath-1H) and plasmapheresis for high-PRA positive lymphocyte crossmatch heart transplant: a strategy to shorten left ventricular assist device support. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 27(9), 1036-9.More infoPatients on a left ventricular assist device (LVAD) often have a high level of panel-reactive antibodies (PRA). Conventional therapy is to await a heart from a negative prospective-crossmatch donor. We transplanted three high-PRA patients with non-crossmatched hearts, using intra- and post-operative plasmapheresis and long-term T-/B-/plasma-cell therapy with alemtuzumab. Three highly sensitized patients (70%, 94% and 96% T-PRA; 63%, 24% and 73% B-PRA) were transplanted after 29, 187 and 94 days LVAD support. The first patient (Case 1) had an erroneous prospective negative crossmatch (due to an outside laboratory's use of the wrong patient's serum) with immediate allograft dysfunction. The correct serum showed a strongly positive crossmatch; plasmapheresis followed by alemtuzumab (20 mg intravenously) shortly after arrival in the ICU resulted in rapid hemodynamic improvement. Encouraged by this success, the next two patients (Cases 2 and 3) underwent LVAD explant and heart transplant with the next available ABO-identical, non-crossmatched donors, using plasmapheresis on bypass immediately before heart implant and alemtuzumab 20 mg intravenously upon ICU arrival, with uneventful courses. All three patients had positive retrospective T- and B-cell crossmatches. Maintenance immunosuppression consisted of cyclosporine and routine prednisone taper, with plasmapheresis as needed (Patient 1, x10; Patient 2, x5) based on diastolic dysfunction. Mycophenolate mofetil was started as a third agent several months post-transplant. Patients are presently New York Heart Association (NYHA) Class I at 26, 16 and 13 months post-transplant. In this small series with follow-up, immediate antibody removal with plasmapheresis, combined with alemtuzumab, a long-acting antibody to CD52 (expressed on T, B and some plasma cells), appears effective in allowing transplantation in sensitized, positive crossmatch recipients. Expanded use of this strategy could shorten LVAD support in many sensitized patients.
- Rapose, A., Lick, S. D., & Ismail, N. (2008). Listeria grayi bacteremia in a heart transplant recipient. Transplant infectious disease : an official journal of the Transplantation Society, 10(6), 434-6.More infoBacteria belonging to the genus Listeria have been isolated from food products of animal, plant, and fish origin, and are associated with infections in immunocompromised hosts, pregnant women, and infants. The species Listeria grayi has rarely been reported as a human pathogen. It has a unique antibiotic sensitivity profile. We describe a case of L. grayi bacteremia in a heart transplant recipient. The organism demonstrated a reduced sensitivity to ampicillin. The patient was successfully treated with a combination of vancomycin and ciprofloxacin.
- Sulemanjee, N. Z., Merla, R., Lick, S. D., Aunon, S. M., Taylor, M., Manson, M., Czer, L. S., & Schwarz, E. R. (2008). The first year post-heart transplantation: use of immunosuppressive drugs and early complications. Journal of cardiovascular pharmacology and therapeutics, 13(1), 13-31.More infoA large number of heart transplants are performed annually in different transplant centers in the United States. This is partly because of the improved survival of patients who undergo cardiac transplantation, thus making it a more viable option in the management of end-stage heart failure. The survival benefit after heart transplantation is a result of newer immunosuppressive drug regimens and a better understanding of their effects and interactions. Several studies, mostly involving a small number of patients, describe use and comparison of the many distinct immunosuppressive drugs available to date. Interestingly, many transplant centers perform in-house typical induction treatment regimens because of their own experience and intra-institutional preference. This review summarizes current practices of immunosuppressive drug therapy in the first year post-heart transplant based on the available clinical evidence and discusses future options of heart transplant immunosuppressive drug therapies.
- Yang, Y., Yang, Y., Xu, Y., Lick, S. D., Awasthi, Y. C., & Boor, P. J. (2008). Endothelial glutathione-S-transferase A4-4 protects against oxidative stress and modulates iNOS expression through NF-kappaB translocation. Toxicology and applied pharmacology, 230(2), 187-96.More infoOur recent work in endothelial cells and human atherosclerotic plaque showed that overexpression of glutathione-S-tranferases (GSTs) in endothelium protects against oxidative damage from aldehydes such as 4-HNE. Nuclear factor (NF)-kappaB plays a crucial role during inflammation and immune responses by regulating the expression of inducible genes such as inducible nitric oxide synthase (iNOS). 4-HNE induces apoptosis and affects NF-kappaB mediated gene expression, but conflicting results on 4-HNE's effect on NF-kappaB have been reported. We compared the effect of 4-HNE on iNOS and the NF-kappaB pathway in control mouse pancreatic islet endothelial (MS1) cells and those transfected with mGSTA4, a alpha-class GST with highest activity toward 4-HNE. When treated with 4-HNE, mGSTA4-transfected cells showed significant upregulation of iNOS and nitric oxide (NO) through (NF)-kappaB (p65) translocation in comparison with wild-type or vector-transfected cells. Immunohistochemical studies of early human plaques showed lower 4-HNE content and upregulation of iNOS, which we take to indicate that GSTA4-4 induction acts as an enzymatic defense against high levels of 4-HNE, since 4-HNE accumulated in more advanced plaques, when detoxification and exocytotic mechanisms are likely to be overwhelmed. These studies suggest that GSTA4-4 may play an important defensive role against atherogenesis through detoxification of 4-HNE and upregulation of iNOS.
- Huang, M., Wang, H., Roeske, W. R., Birnbaum, Y., Wu, Y., Yang, N., Lin, Y., Ye, Y., McAdoo, D. J., Hughes, M. G., Lick, S. D., Boor, P. J., Lui, C. Y., & Uretsky, B. F. (2007). Mediating delta-opioid-initiated heart protection via the beta2-adrenergic receptor: role of the intrinsic cardiac adrenergic cell. American journal of physiology. Heart and circulatory physiology, 293(1), H376-84.More infoStimulation of cardiac beta(2)-adrenergic receptor (beta(2)-AR) or delta-opioid receptor (DOR) exerts a similar degree of cardioprotection against myocardial ischemia in experimental models. We hypothesized that delta-opioid-initiated cardioprotection is mediated by the intrinsic cardiac adrenergic (ICA) cell via enhanced epinephrine release. Using immunohistochemical and in situ hybridization methods, we detected in situ tyrosine hydroxylase (TH) mRNA and TH immunoreactivity that was colocalized with DOR immunoreactivity in ICA cells in human and rat hearts. Western blot analysis detected DOR protein in ICA cells isolated from rat ventricular myocytes. The physiology of DOR expression was examined by determining changes of cytosolic Ca(2+) concentration ([Ca(2+)](i)) transients in isolated rat ICA cells using fluorescence spectrophotometry. Exposing the selective delta-opioid agonist D-[Pen(2,5)]enkephalin (DPDPE) to ICA cells increased [Ca(2+)](i) transients in a concentration-dependent manner. Such an effect was abolished by the Ca(2+) channel blocker nifedipine. HPLC-electrochemical detection demonstrated a 2.4-fold increase in epinephrine release from ICA cells following DPDPE application. The significance of the ICA cell and its epinephrine release in delta-opioid-initiated cardioprotection was demonstrated in the rat myocardial infarction model and ICA cell-ventricular myocyte coculture. DPDPE administered before coronary artery occlusion or simulated ischemia-reperfusion reduced left ventricular infarct size by 54 +/- 15% or myocyte death by 26 +/- 4%, respectively. beta(2)-AR blockade markedly attenuated delta-opioid-initiated infarct size-limiting effect and abolished delta-opioid-initiated myocyte survival protection in rat ICA cell-myocyte coculture. Furthermore, delta-opioid agonist exerted no myocyte survival protection in the absence of cocultured ICA cells during ischemia-reperfusion. We conclude that delta-opioid-initiated myocardial infarct size reduction is primarily mediated via endogenous epinephrine/beta(2)-AR signaling pathway as a result of ICA cell activation.
- Salinas, G., Kumar, D., Lick, S., Vijayakumar, V., Rahman, M., & Uretsky, B. F. (2007). Infective coronary aneurysms: a complication of percutaneous coronary intervention. Texas Heart Institute journal, 34(1), 91-4.More infoWe present the case of a patient who developed infective coronary artery aneurysms after percutaneous coronary artery intervention. We describe the patient's clinical presentation, diagnosis, and treatment, and we review the pertinent medical literature.
- Wang, D., Lick, S. D., Zhou, X., Liu, X., Benkowski, R. J., & Zwischenberger, J. B. (2007). Ambulatory oxygenator right ventricular assist device for total right heart and respiratory support. The Annals of thoracic surgery, 84(5), 1699-703.More infoOur goal is ambulatory total respiratory and right heart assistance allowing a bridge to lung transplant. To that end, we have coupled a compact paracorporeal gas exchange device with a right ventricular assist device (RVAD) to create an "OxyRVAD."
- Carmichael, K. D., Longo, A., Lick, S., & Swischuk, L. (2006). Posterior sternoclavicular epiphyseal fracture-dislocation with delayed diagnosis. Skeletal radiology, 35(8), 608-12.More infoPosterior sternoclavicular joint dislocations and epiphyseal fractures are relatively rare injuries. We present a case report of a 16-year-old male who presented with a 10-day delay in diagnosis. The medial clavicular fragment was widely displaced and rested against the cervical vertebral body. Despite the degree of displacement, the patient had very few symptoms, and the diagnosis was not appreciated in the emergency department and became apparent at 10-day clinic follow-up. Treatment consisted of attempts at closed reduction, which were not successful. Open reduction was performed and the repair done with strong sutures. At 1-year follow-up the patient is doing well without any symptoms. A literature review consisting of anatomy, ossification patterns, classification systems, diagnosis and associated symptoms, imaging recommendations, treatment recommendations, outcomes, and complications is included.
- Conti, V., & Lick, S. D. (2006). Cardiac surgery in the elderly: indications and management options to optimize outcomes. Clinics in geriatric medicine, 22(3), 559-74.More infoThe elderly have increasingly benefited from the advances in cardiac surgical techniques and perioperative care. Compared to the same procedures in younger patients their operations can be more technically demanding and their level of reserve leaves less margin should complications occur. The importance of using realistic indications for operations with a focus on improving the quality of their lives and of optimal preoperative preparation of patients is emphasized.
- Kollar, A., Lick, S. D., Vasquez, K. N., & Conti, V. R. (2006). Relationship of atrial fibrillation and stroke after coronary artery bypass graft surgery: when is anticoagulation indicated?. The Annals of thoracic surgery, 82(2), 515-23.More infoAtrial fibrillation (AF) is considered as a risk factor for stroke after coronary artery bypass grafting operations.
- Rangasetty, U. C., Raza, S., Lick, S., Uretsky, B. F., & Birnbaum, Y. (2006). Chronic pseudoaneurysm and coarctation of the aorta: a rare delayed complication of trauma. Texas Heart Institute journal, 33(3), 368-70.More infoWe report an unusual case of pseudoaneurysm and coarctation of the descending thoracic aorta after trauma. The coarctation of aorta resulted in hypertension, severe left ventricular dysfunction, and symptoms of congestive heart failure. Surgical bypass resulted in control of blood pressure and improvement of heart failure symptoms. The mechanism of aortic injury leading to the development of this rare combination is discussed.
- Mandava, P., Lick, S. D., Rahman, M. A., Langsjoen, H., Reddy, K. V., Nelson, J., & Kent, T. A. (2005). Initial safety experience of abciximab and heparin for acute ischemic stroke. Cerebrovascular diseases (Basel, Switzerland), 19(4), 276-8.
- Zhou, X., Loran, D. B., Wang, D., Hyde, B. R., Lick, S. D., & Zwischenberger, J. B. (2005). Seventy-two hour gas exchange performance and hemodynamic properties of NOVALUNG iLA as a gas exchanger for arteriovenous carbon dioxide removal. Perfusion, 20(6), 303-8.More infoAcute respiratory failure is complicated by acidosis and altered end-organ perfusion. NOVA-LUNG iLA is an interventional lung assist (ILA) device for arteriovenous carbon dioxide removal (AVCO2R). The present study was conducted to evaluate the device for short-term CO2 removal performance and hemodynamic response.
- Birnbaum, Y., Chamoun, A. J., Anzuini, A., Lick, S. D., Ahmad, M., & Uretsky, B. F. (2003). Ventricular free wall rupture following acute myocardial infarction. Coronary artery disease, 14(6), 463-70.More infoVentricular free wall rupture remains a dreaded complication of acute myocardial infarction. A dramatic fatal presentation is not universal and if recognized early, especially in its sub-acute form, a therapeutic intervention may be lifesaving. Changing trends in its natural history and the previously described pathological subtypes have emerged since the advent of thrombolysis. Although frequently unpredictable, certain clinical, echocardiographic and electrocardiographic signs should suggest the diagnosis. Moreover, knowledge of predisposing risk factors and a high index of suspicion are helpful in early recognition of this complication. In recent years, several different therapeutic approaches have been described including percutaneous seals and surgical mechanical closure of ventricular free wall rupture. In this review, we sought to highlight established and debatable aspects of this pathology to hopefully enhance prompt diagnosis and treatment by all clinicians caring for patients suffering acute myocardial infarction.
- Asimakis, G. K., Lick, S., & Patterson, C. (2002). Postischemic recovery of contractile function is impaired in SOD2(+/-) but not SOD1(+/-) mouse hearts. Circulation, 105(8), 981-6.More infoReactive oxygen species (ROS) contribute to myocardial stunning. Superoxide dismutase (SOD) is a major defense mechanism against ROS. The purpose of this study was to evaluate the contributions of cytosolic (SOD1) and mitochondrial (SOD2) isoforms to protect against myocardial stunning.
- Duarte, A. G., & Lick, S. (2002). Perioperative care of the lung transplant patient. Chest surgery clinics of North America, 12(2), 397-416.More infoImprovements in the perioperative management of lung transplant recipients have produced a 90% survival in the first 30 days following surgery. Detailed attention to donor organ procurement and preservation of the allograft are important in ensuring an early successful outcome. Early antibacterial administration based on donor or pretransplant cultures and antiviral therapy in CMV-negative recipients assist in avoiding early infectious complications. Development of hypoxemia or hemodynamic instability in the perioperative period requires a rapid, systematic evaluation with attention to mechanical, immunologic, or infectious causes. Nonpulmonary complications are not infrequent in lung transplant recipients.
- Kurusz, M., Roach, J. D., Vertrees, R. A., Girouard, M. K., & Lick, S. D. (2002). Leukocyte filtration in lung transplantation. Perfusion, 17 Suppl, 63-7.More infoControlled reperfusion of the transplanted lung has been used in nine consecutive patients to decrease manifestations of lung reperfusion injury. An extracorporeal circuit containing a roller pump, heat exchanger and leukodepleting filter is primed with substrate-enhanced reperfusion solution mixed with approximately 2000 ml of the patient's blood. This solution is slowly recirculated to remove leukocytes prior to reperfusion. When the pulmonary anastomoses are completed, the pulmonary artery is cannulated through the untied anastomosis using a catheter containing a pressure lumen for measurement of infusion pressure. An atrial clamp is left in place on the patient's native atrial cuff to decrease the risk of systemic air embolism during the brief period of reperfusion from the extracorporeal reservoir. During reperfusion, the water bath to the heat exchanger is kept at 35 degrees C and the flow rate for reperfusion solution is between 150 and 200 m/min, keeping the pulmonary artery pressure
- Zwischenberger, J. B., Wang, D., Lick, S. D., Deyo, D. J., Alpard, S. K., & Chambers, S. D. (2002). The paracorporeal artificial lung improves 5-day outcomes from lethal smoke/burn-induced acute respiratory distress syndrome in sheep. The Annals of thoracic surgery, 74(4), 1011-6; discussion 1017-8.More infoOur low-impedence, paracorporeal artificial lung (PAL) prototype is well-tolerated in-series with the normal sheep pulmonary circulation. Using our lethal dose 80% to 100% smoke/burn acute respiratory distress syndrome (ARDS) sheep model, we compared PAL to volume-controlled mechanical ventilation (VCMV) in a prospective, randomized, controlled, unblinded, 5-day outcome study.
- Lick, S. D., Zwischenberger, J. B., Wang, D., Deyo, D. J., Alpard, S. K., & Chambers, S. D. (2001). Improved right heart function with a compliant inflow artificial lung in series with the pulmonary circulation. The Annals of thoracic surgery, 72(3), 899-904.More infoWe previously reported a 50% incidence of immediate right heart failure using a rigidly housed, noncompliant inflow artificial lung in series with the pulmonary circulation in a healthy ovine survival model. Three device modifications resulted: (1) an inflow cannula compliance chamber, (2) an inlet blood flow separator, and (3) modification of the artificial lung outlet geometry, all to reduce resistance and mimic the compliance of the pulmonary vascular bed.
- Lick, S. (2000). Surgical therapy for cardiomyopathy. The American journal of the medical sciences, 320(2), 135-43.
- Kurusz, M., Lick, S. D., & Conti, V. R. (1998). Air embolism with intraaortic balloon counterpulsation during cardiopulmonary bypass. The Journal of thoracic and cardiovascular surgery, 115(6), 1393.
- Asimakis, G. K., Lick, S. D., & Conti, V. R. (1996). Transient ischemia cannot precondition the rabbit heart against postischemic contractile dysfunction. The Annals of thoracic surgery, 62(2), 543-8; discussion 549.More infoThe rat heart is preconditioned against postischemic contractile dysfunction by a brief period of transient ischemia before a prolonged ischemic period. However, the rabbit heart does not receive such cardio-protection from pretreatment with a single transient ischemia periods. We hypothesized that in the rabbit heart, a multiple cycle of transient ischemia is required to reach a threshold necessary to precondition against postischemic contractile dysfunction.
- Lick, S. D., Conti, V. R., Zwischenberger, J. B., & Kurusz, M. (1996). Simple technique of left heart bypass. The Annals of thoracic surgery, 61(5), 1555-6.More infoLeft heart bypass is typically established by left atrial appendage cannulation. We report a technique using inferior pulmonary vein cannulation, which is technically simpler. We have used this technique in 20 cases with reliable venous inflow.
- Lick, S. D., & Zwischenberger, J. B. (1995). Endocarditis -- when to operate?. ACC Current Journal Review, 21-23.
- Lick, S. D., Copeland, J. G., Rosado, L. J., Arabia, F. A., & Sethi, G. K. (1995). Simplified technique of heart-lung transplantation. The Annals of thoracic surgery, 59(6), 1592-3.More infoWell-known complications of heart-lung transplantation include mediastinal bleeding and phrenic nerve injury. Conventional technique places the hila behind the phrenic nerves. We have placed the hila in front of the phrenic nerve in our last 10 patients, using direct caval anastomoses when feasible. This minimizes traction on and dissection around the phrenic nerves, and allows anterior rotation of the heart-lung block for easier hemostasis of the posterior mediastinum after implantation.
- Lick, S., Copeland, J. G., Smith, R. G., Cleavinger, M., Rosado, L. J., Huston, C. L., Sethi, G. K., & Molloy, T. F. (1993). Use of the Symbion biventricular assist device in bridging to transplantation. The Annals of thoracic surgery, 55(1), 283-7.More infoFrom 1988 to 1991 13 patients received Symbion biventricular assist devices in attempts to bridge them to cardiac transplantation. All 7 of those who had cardiac transplants survived to hospital discharge. One death occurred 60 days after transplantation because of rejection. All other patients who received transplants are surviving. Implant times in this group varied from 10 to 164 days (mean, 55 days). There were two embolic neurologic events and two significant infections, and 2 of the survivors were dialyzed for reversible renal failure before transplantation. Of those who died on device support, 3 presented on centrifugal pump support. The three other deaths were caused by graft rejection, multiple organ failure, and multiple peripheral emboli. Biventricular assist devices optimally provide cardiac outputs of 4 to 5 L/min, can be quickly inserted often without requiring cardiopulmonary bypass, are easily explanted, and seem best suited for patients weighing less than 80 kg.
- Rappaport, W. D., Valente, J., Hunter, G. C., Rance, N. E., Lick, S., Lewis, T., & Neal, D. (1993). Clinical utilization and complications of sural nerve biopsy. American journal of surgery, 166(3), 252-6.More infoSurgeons frequently perform sural nerve biopsy as part of the work-up of patients with peripheral neuropathy. The indications for the procedure, therapeutic value, and complications associated with the procedure have received little attention in the surgical literature. A retrospective chart review of 60 patients with the suspected diagnosis of peripheral neuropathy undergoing sural nerve biopsy was performed. Vasculitis was suspected in 29 (48%) patients undergoing biopsy. This diagnosis was confirmed in 6 of the 29 patients and resulted in the alteration of therapy in 31% of patients with this suspected diagnosis. In 27 (45%) patients, the etiology of their peripheral neuropathy was unknown. Twelve (44%) patients in this group had sural nerve pathology; however, no change in therapy was required. Ten patients in our series had associated malignant tumors; some of these patients were diagnosed after referral for sural nerve biopsy. Twenty-five (42%) patients remained undiagnosed after biopsy. Nerve conduction studies were performed in 14 (22%) patients. Thirteen patients with abnormal lower extremity nerve conduction studies had 6 normal and 7 abnormal biopsy results. The one patient with a normal study had a normal nerve biopsy result. There were six (10%) patients with wound infections, seven (12%) patients with delayed wound healing, and three (5%) patients with new onset of chronic pain in the distribution of the sural nerve, for an overall complication rate of 27%. There was no correlation between the preoperative use of antibiotics, type of local anesthetic used, or length of nerve excised and complication rate. We conclude that the complication rate after sural nerve biopsy is significant. Strict criteria should be employed in selecting patients for sural nerve biopsy including a careful neurologic history and physical examination, nerve conduction studies, appropriate work-up for vasculitis if suspected, and implementation of a search for malignancy if this is not apparent. If the diagnosis is still in question, then sural nerve biopsy would seem appropriate, especially in patients with suspected vasculitis.
- Rappaport, W. D., Valente, J., Hunter, G. C., Rance, N. E., Lick, S., Lewis, T., & Neal, D. (1993). Clinical utilization and complications of sural nerve biopsy. The American Journal of Surgery, 166(3), 252-256.More infoPMID: 8396357;Abstract: Surgeons frequently perform sural nerve biopsy aspart of the work-up of patients with peripheral neuropathy. The indications for the procedure, therapeutic value, and complications associated with the procedure have received little attention in the surgical literature. A retrospective chart review of 60 patients with the suspected diagnosis of peripheral neuropathy undergoing sural nerve biopsy was performed. Vasculitis was suspected in 29 (48%) patients undergoing biopsy. This diagnosis was confirmed in 6 of the 29 patients and resulted in the alteration of therapy in 31% of patients with this suspected diagnosis. In 27 (45%) patients, the etiology of their peripheral neuropathy was unknown. Twelve (44%) patients in this group had sural nerve pathology; however, no change in therapy was required. Ten patients in our series had associated malignant tumors; some of these patients were diagnosed after referral for sural nerve biopsy. Twenty-five (42%) patients remained undiagnosed after biopsy. Nerve conduction studies were performed in 14(22%) patients. Thirteen patients with abnormal lower extremity nerve conduction studies had 6 normal and 7 abnormal biopsy results. The one patient with a normal study had a normal nerve biopsy result. There were six (10%) patients with wound infections, seven (12%) patients with delayed wound healing, and three (5%) patients with new onset of chronic pain in the distribution of the sural nerve, for an overall complication rate of 27%. There was no correlation between the preoperative use of antibiotics, type of local anesthetic used, or length of nerve excised and complication rate. We conclude that the complication rate after sural nerve biopsy is significant. Strict criteria should be employed in selecting patients for sural nerve biopsy including a careful neurologic history and physical examination, nerve conduction studies, appropriate work-up for vasculitis if suspected, and implementation of a search for malignancy if this is not apparent. If the diagnosis is still in question, then sural nerve biopsy would seem appropriate, especially in patients with suspected vasculitis. © 1993 Reed Publishing USA.
- Lick, S., Rappaport, W. D., & McIntyre, K. E. (1991). Successful epicardial pacing in blunt trauma resuscitation. Annals of Emergency Medicine, 20(8), 908-909.More infoPMID: 1854078;Abstract: Epicardial pacing wires were used successfully in the resuscitation of a moribund victim of blunt trauma after fluid resuscitation and chemical measures had failed. Application of these wires to treat the bradycardia of shock should be considered in selected patients when standard measures fail. © 1991 American College of Emergency Physicians.
- Rappaport, W. D., Hunter, G. C., Allen, R., Lick, S., Halldorsson, A., Chvapil, T., Holcomb, M., & Chvapil, M. (1990). Effect of electrocautery on wound healing in midline laparotomy incisions. American journal of surgery, 160(6), 618-20.More infoThe effect of electrocautery on midline fascial wound healing was studied in 108 Sprague-Dawley rats. Midline wound tensile strength was significantly reduced in fascia incised with the coagulation current compared with the cutting current or scalpel. In addition, tissue necrosis and inflammation as well as adhesion formation between the incision and abdominal viscera were more extensive in animals with incisions made using coagulation current. The results of the study indicate that the use of electrocautery coagulation current is associated with increased tissue damage and a significant reduction in the tensile strength of healing wounds. The contribution of electrocautery to wound complications in patients needs further evaluation.
- Rappaport, W. D., Hunter, G. C., Allen, R., Lick, S., Halldorsson, A., Chvapil, T., Holcomb, M., & Chvapil, M. (1990). Effect of electrocautery on wound healing in midline laparotomy incisions. The American Journal of Surgery, 160(6), 618-620.More infoPMID: 2147542;Abstract: The effect of electrocautery on midline fascial wound healing was studied in 108 Sprague-Dawley rats. Midline wound tensile strength was significantly reduced in fascia incised with the coagulation current compared with the cutting current or scalpel. In addition, tissue necrosis and inflammation as well as adhesion formation between the incision and abdominal viscera were more extensive in animals with incisions made using coagulation current. The results of the study indicate that the use of electrocautery coagulation current is associated with increased tissue damage and a significant reduction in the tensile strength of healing wounds. The contribution of electrocautery to wound complications in patients needs further evaluation. © 1990 Reed Publishing USA.
- Hsu, C., Malo, J., Mosier, J. M., Natt, B., Hypes, C., Lick, S. D., & Bull, D. A. (2019, May/). Duration and Outcomes of Veno-Venous Extracorporeal Membrane Oxygenation Support in Acute Respiratory Distress Syndrome: Results from ELSO database. American association for thoracic surgery 99th annual meeting. Toronto: American association for thoracic surgery.
- Kazui, T., Bull, D. A., Hsu, C., Hsu, C., Lick, S. D., Lick, S. D., Bull, D. A., & Kazui, T. (2019, January). Does use of bilateral mammary arteries increase short-term risk in diabetic patients? Results from The Society of Thoracic Surgeons Adult Cardiac Surgery Database. 55th STS annual meeting. San Diego: STS.
- Kazui, T., Hsu, C., Lick, S. D., & Bull, D. A. (2019, October). Venovenous extracorporeal membrane oxygenation and risk factors for adverse outcomes in acute respiratory distress syndrome: Results from the extracorporeal life support organization database. 2nd Annual Scientific Meeting of the Japanese Association for Thoracic Surgery. Kyoto, Japan: Japanese Association for Thoracic Surgery.
- Cosgrove, R., Basken, R., Kazui, T., Smith, R., Finger, J., Lick, S. D., & Khalpey, Z. I. (2017, Oct). A “Goldilocks” experience with various enoxaparin bridge doses reflected by thromboelastogram results in total artificial heart patients. The 2017 ISMCS Conference. Tucson: ISMCS.
- Cosgrove, R., Finger, J., Kazui, T., Smith, R., Basken, R., Lick, S. D., & Khalpey, Z. I. (2017, Oct). Heparin induced thrombocytopenia in left ventricular assist device patients: Therapeutic considerations. The 2017 ISMCS Conference. Tucson: ISMCS.
- Kazui, T., Lick, S. D., Avery, R., Juneman, E. B., Cook, J., Sweitzer, N. K., & Khalpey, Z. I. (2017, Oct). Minimally invasive off-pump HVAD vs full sternotomy on-pump LVAD placement: comparison of clinical outcomes. The 2017 ISMCS Conference. Tucson: ISMCS.
- Kazui, T., Lick, S. D., Avery, R., Juneman, E. B., Cook, J., Sweitzer, N. K., & Khalpey, Z. I. (2017, Oct). The effectiveness of minimally invasive off pump HVAD placement in redo patients. The 2017 ISMCS Conference. Tucson: ISMCS.
- Shah, S. K., Parto, P., Lombard, G. A., James, M. A., Beckles, D. L., Lick, S. D., & Valentine, V. G. (2012, November). Phaeocremonium Parasiticum as a cause of cavitary native lung nodules after single lung transplantation. International Society for Heart and Lung Transplantation. Prague: ISHLT.More infoposter, ISHLT 2012, Prague
- Valentine, V. G., Carey, B., Lombard, G. A., James, M. A., Chalk, C., Wert, S., Suzuki, T., Lick, S., & Trapnell, B. C. (2012, May). Cellular and molecular biomarkers of the onset of autoimmune pulmonary alveolar proteinosis after lung transplantation. American Thoracic SocietyAmerican Thoracic Society.More infoAmerican Thoracic Society, poster 237, 2012
- Lick, S. D. (2010, May). Limited veno-venous extracorporeal carbon dioxide removal for severe primary graft dysfunction after lung transplantation. Annals of Thoracic Surgery.More infoposter sessionSTS May 2010
- Arain, F. A., Williams, B. D., Lick, S. D., Boroumand, N., & Ahmad, M. (2013. Echocardiographic, histopathologic, and surgical findings in Staphylococcus lugdunensis mitral valve endocarditis after prostate biopsy(pp e204-6).
- Havins, J., Lick, S., Boor, P., Arora, H., & Ahmad, M. (2013. Real time three-dimensional transesophageal echocardiography in partial posteromedial papillary muscle rupture(pp E179-81).More infoA 60-year-old hypertensive male with non-ST segment elevation myocardial infarction had a hyperdynamic LV with mild posterior leaflet mitral valve prolapse without significant regurgitation on transthoracic echocardiogram. Two-dimensional (2D) TEE showed severe mitral regurgitation with prolapse of P2 and P3 scallops. Posteromedial papillary muscle rupture was suspected. Three-dimensional (3D) TEE demonstrated severely prolapsing P2 and P3 valve scallops with a clear view of the partially ruptured posteromedial papillary muscle. Patient underwent emergency coronary bypass and mitral valve replacement. Surgical pathology of papillary muscle confirmed coagulative necrosis. 3D TEE was superior in identifying the partial posteromedial papillary muscle rupture.
- Shah, S. K., Parto, P., Lombard, G. A., James, M. A., Beckles, D. L., Lick, S., & Valentine, V. G. (2013. Probable Phaeoacremonium parasiticum as a cause of cavitary native lung nodules after single lung transplantation(pp E9-13).More infoLung nodules after lung transplantation most often represent infection or post-transplant lymphoproliferative disorder in the allograft. Conversely, native lung nodules in single lung transplant recipients are more likely to be bronchogenic carcinoma. We present a patient who developed native lung cavitary nodules. Although malignancy was anticipated, evaluation revealed probable Phaeoacremonium parasiticum infection. Phaeoacremonium parasiticum is a dematiaceous fungus first described as a cause of soft tissue infection in a renal transplant patient. Lung nodules have not been previously described and this is the first case, to our knowledge, of P. parasiticum identified after lung transplantation.
- Kochar, R., Pandey, R., Mileski, W., Lick, S. D., Schreiber, M. H., & Parupudi, S. V. (2012. Endoscopic retrograde cholangiopancreatography (ERCP)-related esophageal perforation in osteogenesis imperfecta(pp 238-9).
- Lick, S. D., Beckles, D. L., & Conti, V. R. (2012. Simple technique to preserve the LSVC during reoperative orthotopic heart transplant(pp 767-8).More infoIncreasingly, patients undergo heart transplant after previous heart surgery. In patients with a persistent left superior vena cava (LSVC), the preferred technique, preservation of drainage via the native coronary sinus, can be difficult in reoperative cases due to adhesions. We report a technique simplifying this operation in such a patient.
- Cabada, M. M., Nishi, S. P., Lea, A. S., Schnadig, V., Lombard, G. A., Lick, S. D., & Valentine, V. G. (2010. Concomitant pulmonary infection with Nocardia transvalensis and Aspergillus ustus in lung transplantation(pp 900-3).More infoLung infections with Nocardia and Aspergillus spp in lung transplant recipients (LTRs) create diagnostic and therapeutic challenges. The present case illustrates the difficulties in identifying these pathogens in LTRs. A high degree of clinical suspicion and aggressive early management are required to ensure good outcomes. Although prospective data on treating these conditions are scarce, the empiric use of combination broad-spectrum anti-microbials initially seems prudent.
- Kollar, A. C., Lick, S. D., Palacio, D. M., & Johnson, R. F. (2009. Ross procedure with a composite autograft using stretch Gore-Tex material(pp e34-6).More infoIn an attempt to allow physiologic expansion of the pulmonary autograft, yet limit late root dilation, we used stretch Gore-Tex material (W. L. Gore & Assoc, Flagstaff, AZ) as an external wrap. Follow-up cardiac computed tomography with reconstructed three-dimensional and dynamic images confirmed normal "triple bulge" sinus Valsalva geometry and preserved natural systolic expansion of the neoaortic root.
- Woodside, K. J., & Lick, S. D. (2007. Alemtuzumab (Campath 1H) as successful salvage therapy for recurrent steroid-resistant heart transplant rejection(pp 750-2).More infoWe report the case of a heart transplant recipient who presented twice in profound cardiogenic shock at Months 4 and 8 post-transplant. She had unsuccessful conventional rejection therapy, but responded dramatically to alemtuzumab salvage therapy. Both times, her recovery onset was strikingly parallel to that described after using alemtuzumab as salvage therapy in renal transplantation. The reported use of alemtuzumab in thoracic organ transplant is rare. We believe this is the first reported case of alemtuzumab as salvage therapy in heart transplantation.
- Duarte, A. G., Sattar, F., Granwehr, B., Aronson, J. F., Wang, Z., & Lick, S. (2006. Disseminated acanthamoebiasis after lung transplantation(pp 237-40).More infoProtozoan infections in organ transplant recipients are rare. We report a fatal case of disseminated acanthamoebiasis in a bilateral lung transplant recipient that presented with cutaneous lesions, respiratory failure, and seizures. Acanthamoeba infection may be identified in transplant recipients with exposure to water who develop non-healing cutaneous ulcers with granulomatous inflammation. Cutaneous lesions are the initial manifestation of infection and a harbinger of dissemination. Early institution of combination anti-microbial therapy is therefore necessary for effective treatment and prevention of lethal spread to the central nervous system.
- Helmy, T. A., Nicholson, W. J., Lick, S., & Uretsky, B. F. (2005. Contained myocardial rupture: a variant linking complete and incomplete rupture(pp e13).More infoMyocardial rupture is an uncommon complication of myocardial infarction, often with devastating haemodynamic consequences. Although rupture is usually fatal, when patients do survive, the majority present with a pseudoaneurysm in which the rupture is sealed by a haematoma on the epicardial surface of the heart. Cases in which all myocardial layers are dissected except the epicardium or visceral pericardium have been included under this subheading. The authors describe such a case and suggest the pathological description of a "contained myocardial rupture". This link between complete and incomplete myocardial rupture may allow a more conservative management approach to be pursued.
- Lick, S. D., Edozie, S. N., Woodside, K. J., & Conti, V. R. (2005. Streptococcus viridans endocarditis from tongue piercing(pp 57-9).More infoBody piercing and tattooing have undergone a revival in popularity. We present the case of a 27-year-old man with a recent tongue piercing and infective endocarditis of the aortic valve. He was treated with a 6-week course of intravenous antibiotics, but eventually required a Ross procedure for progressive aortic insufficiency.
- Lick, S., & Conti, V. (1999. Thrombolysis with resolution of pulmonary hypertension in a heart transplant candidate(pp 896-7).More infoWe report a patient with idiopathic cardiomyopathy and high pulmonary resistance due to pulmonary emboli of unknown age. Successful thrombolytic therapy returned his pulmonary resistance to normal, allowing orthotopic cardiac transplantation. This case underscores the need to aggressively diagnose and treat pulmonary emboli in potential transplant candidates.
- Lick, S. D., Sankar, A. B., & Boor, P. J. (1998. Heart donation after lightning strike(pp 1034-5).More infoWe present the first reported case of heart donation after lightning strike. Approximately 150 to 300 generally young and healthy people die from lightning strike in the United States each year. These unfortunate victims may make good heart donors. Pertinent pathophysiology of lightning strike is briefly reviewed.
- Lick, S. D., & Conti, V. R. (1997. Automatic internal cardioverter-defibrillator patch erosion into the upper airway presenting as a cavitary lesion(pp 1144-6).More infoErosion of an automatic internal cardioverter-defibrillator (AICD) patch into the lingular bronchus occurred 4 years after implantation; the erosion presented as a cavitary mass associated with hemoptysis and weight loss. On bronchoscopy to evaluate for suspected carcinoma, a cavity was entered through a bronchial defect and the AICD patch clearly identified. The complication was successfully treated with patch removal and fistula closure.
- Lick, S. D., Zwischenberger, J. B., Mileski, W. J., & Ahmad, M. (1997. Torn ascending aorta missed by transesophageal echocardiography(pp 1768-70).More infoTransesophageal echocardiography has become a commonly used screening tool for traumatic tears of the descending aorta. The role of transesophageal echocardiography for ascending aortic tears is not yet well-defined. We report an ascending aortic tear imaged by aortography but missed on transesophageal echocardiography.
- Lick, S., Copeland, J. G., Rosado, L. J., Sethi, G., Smith, R. G., & Cleavinger, M. (1991. Long-term bridge to transplantation with the Symbion acute ventricular assist device system(pp 308-9).More infoA 48-year-old man was supported for 164 days with Symbion biventricular assist devices. During that time, his cytotoxic antibody screen fell from 97% positivity to less than 10%, enabling cardiac transplantation. Complications during the implantation included a 3-minute episode of amaurosis fugax, one positive blood culture, and anemia, which responded to decreased frequency of blood drawing. He is now alive 7 months after transplantation.
- Lick, S., Rappaport, W. D., & McIntyre, K. E. (1991. Successful epicardial pacing in blunt trauma resuscitation(pp 908-9).More infoEpicardial pacing wires were used successfully in the resuscitation of a moribund victim of blunt trauma after fluid resuscitation and chemical measures had failed. Application of these wires to treat the bradycardia of shock should be considered in selected patients when standard measures fail.
- Wang, D., Lick, S. D., Campbell, K. M., Loran, D. B., Alpard, S. K., Zwischenberger, J. B., & Chambers, S. D. (2016, Spring). Development of ambulatory arterio-venous carbon dioxide removal (AVCO2R): the downsized gas exchanger prototype for ambulation removes enough CO2 with low blood resistance. ASAIO journal (American Society for Artificial Internal Organs : 1992).More infoWe are developing an ultra compact gas exchanger to allow ambulation during arterial-venous CO2 removal (AVCO2R). The ambulatory AVCO2R gas exchanger (135 ml prime volume and 1.3 M2 gas exchange surface area) is made of polymethylpentene hollow fibers. The gas exchanger was attached to sheep carotid artery (12F) and jugular vein (14F) by percutaneous cannulae for 6 hours (n = 5). Device CO2 removal was measured and calculated at a constant blood flow rate of 1 L/min coupled with varying sweep gas from 1 to 15 L/min, and at constant sweep gas flow of 2 L/min coupled with varying blood flow from 0.5 to 1.25 L/min to determine capacity of CO2 removal at Pa CO2 = 40-50 mm Hg. Blood gases, CO2 removal and hemodynamics were recorded at 0, 3, and 6 hours. CO2 removal increased with sweep gas flow rate and with increase of device blood flow. Hemodynamics remained unchanged throughout study. Gas exchanger resistance remained stable at 2.3 +/- 0.53 mm Hg/L/min. CO2 removal with 1 L/min blood flow and 2 L/min sweep gas was 110 +/- 12 then stabilized at 85 +/- 14 mL/min to 6 hours. The compact ambulatory AVCO2R gas exchanger achieves stable, near total CO2 removal for at least 6 hours with a simple arteriovenous shunt.
- Lick, S. D. (2012, January). letter to the editor (cautionary note). Journal of Innovations in Cardiac Rhythm Management.More infoletter to the editor (cautionary note)Journal of Innovations in Cardiac Rhythm Management, 3 (2012), 921
- Lick, S. D., & Beckles, D. L. (2012, January). A pulmonary artery "chimney" relieves RVAD anxiety. Annals of Thoracic Surgery.More infoletter to the editorAnnals of Thoracic Surgery 2012; 94(5):1784-5
- Lick, S. D. (2011, April). Analysis of Non-Cutaneous Cancer after Lung Transplantation. The Journal of Heart and Lung Transplantation.More infoabstractJHLT 30 (4S), S149, 2011
- Kislingbury, K. K., Kollar, A. C., Koerner, M. M., Barbagelata, N. A., Valentine, V. G., & Lick, S. D. (2010, February). Alemtuzumab, a promising tool in the rescue armamentarium for refractory allograft dysfunction with cardiogenic shock: experience from a single institution. The Journal of Heart and Lung Transplantation.More infoabstractJHLT 29(2), Suppl 1, S159-160 (abstract 487), 2010
- Lick, S. D., Kislingbury, K. K., Kollar, A. C., Barbagelata, N. A., Koerner, M. M., & Valentine, V. G. (2010, February). Highly sensitized LVAD patients can be safely transplanted with non-crossmatched hearts using plasmapheresis and alemtuzumab: a contemporaneous case-control series. The Journal of Heart and Lung Transplantation.More infoabstractJHLT 29(2), Suppl 1 (abstract 175), S63, 2010
- Pillai, R. R., Valentine, V. G., Lick, S. D., Lombard, G. A., LaPlace, S. G., McAnally, K. J., & Seoane, L. (2010, February). Analysis of Nontuberculous Mycobacteria infections in lung transplant recipients. the Journal of Heart and Lung Transplantation.More infoabstractJHLT 29(2), Suppl 1, S138 (abstract 417), 2010
- Lick, S. D. (2008, October). Perioperative Alemtuzumab (Compath 1-H) and plasmapheresis for high-PRA, positive lumphocyte-crossmatch heart transplant: a strategy to shorten LVAD support. The Journal of Heart and Lung Transplantation.More infoabstractJHLT, Vol 27, issue 2, s158 (abstract #271)
- Lick, S. D. (2007, November). HIF-1, VEGF and NFKB in Primary Lung Hypertension (PH) in a Sheep Model. United States Academy of Pathology, 2007 meeting.More infoabstract
- Lick, S. D. (2005, summer 2005). RESTORE--from deduction to leap of faith. Journal of the American College of Cardiology.
- Lick, S. D. (2004, January). Use of an arteriovenous fistula to make a patient "appear larger" to her LVAD. J Heart Lung Transplant 2004.More infoletter to the editorJ Heart Lung Transplant 2004; 23(1), 150-1
- Lick, S. D. (2004, May). A less traumatic surgical technique for paracorporeal RVAD attachment in sheep. American Society for Artificial Internal Organs.More infoabstractASAIO Abstracts 2004:50(2):133
- Lick, S. D. (2004, May). Development of compact paracorporeal right heart and lung assist device (RH&LD). American Society for Artificial Internal Organs.More infoabstractASAIO Abstracts 2004;50(2):154
- Lick, S. D. (2003, April). Development of ambulatory arteriovenous CO2 removal (AAVCO2R). American Society for Artificial Internal Organs.More infoabstractASAIO Abstracts 2003;49(2):182
- Lick, S. D. (2003, March). An assisted compliance chamber in an artificial lung in series with the pulmonary circulation. American Society for Artificial Internal Organs.More infoabstractASAIO Abstracts 2003;49(2):182
- Lick, S. D. (2003, May). Assessment of cough reflex in lung transplant recipients. Annals of Thoracic Surgery.More infoabstract ATS 2003 Seattle
- Lick, S. D. (2003, October). letter to the editor. JACC 2003.More infoletter to the editorJACC 2002;42(6):1532 (Oct)
- Lick, S. D. (2002, April). Development of ambulatory arteriovenous carbon dioxide removal (AVCO2R). American Society for Artificial Internal Organs.More infoabstractASAIO Abstracts 48(2), 153
- Lick, S. D. (2002, February). The Paracorporeal Artificial Lung (PAL) Improves Outcomes from Lethal Smoke/Burn-Induced ARDS in Sheep. Society of Thoracic Surgeons.More infoabstractSociety of Thoracic Surgeons, 2002
- Lick, S. D. (2002, March). Of Mycetomas and Men. Chest 2002.More infoinvited editorialChest 2002; 121(1):5-6
- Lick, S. D. (2002, March). Predicting outcome in Primary Graft Failure. Chest 2002.More infoinvited editorialChest 2002; 121(6):1736-8
- Lick, S. D. (2002, May). invited book review. Ann Thorac Surg 2002.More infoinvited book review (extracorporeal Life Support by Dan M Meyer and Michael JessenAnn Thorac Surg 2002;73:1816
- Lick, S. D. (2001, January). Controlled Reperfusion of the Transplanted Lung. Ann Thorac Surg 2001.More infoletter, replyAnn Thorac Surg 2001; 71:1756
- Lick, S. D. (2001, October). Improved right heart function with a compliant inflow artificial lung in-series with the pulmonary circulation. Society of Thoracic Surgeons 37th annual meeting.More infoabstractSociety of Thoracic Surgeons 37th annual meeting, 2001 p.230
- Lick, S. D. (2000, January). Controlled pulmonary reperfusion: what is the optimal method of delivery?. Ann Thorac Surg 2000.More infoletter; replyAnn Thorac Surg 200;70:1450
- Lick, S. D. (2000, January). Management of complications during development of an ambulatory paracorporeal artificial lung. American Society for Artificial Internal Organs.More infoabstractASAIO J 2000;1:47(2):114
- Lick, S. D. (2000, March). A prototype low-resistance total artificial lung in series with the pulmonary circulation. American Society for Artificial Internal Organs.More infoabstractASAIO Abstracts 2000;46(2):181
- Lick, S. D. (2000, March). Anatomic study of the pulmonary artery as a conduit for an artificial lung. American Society for Artificial Internal Organs.More infoabstractASAIO Abstracts 2000;46(2):184
- Lick, S. D. (2000, March). Artificial lung prototype development. American Society for Artificial Internal Organs.More infoabstractASAIO abstracts 2000; 46(2):230
- Lick, S. D., Brown, P. S., Kurusz, M., Vertrees, R. A., McQuitty, C. K., & Johnston, W. E. (2000). Technique of controlled reperfusion of the transplanted lung in humans. The Annals of thoracic surgery.More infoReperfusion injury remains a significant and sometimes fatal problem in clinical lung transplantation. Controlled reperfusion of the transplanted lung using white cell-filtered, nutrient-enriched blood has been shown recently to significantly ameliorate reperfusion damage in a porcine model. We modified this experimental technique and applied it to human lung transplantation.
- Lick, S. D. (1999, April). Total artificial lung perioperative management: A 7-day survival study in sheep. Crit C Med.More infoabstractCrit C Med 1999;27(12 Suppl.), A22
- Lick, S. D. (1999, September). Early loss of ischemic preconditioning with aging in the rat heart. International Society for Heart Research.More infoabstractISHR, 1999
- Lick, S. D. (1998, October). conventional ventilation is superior to low- or high-frequency ventilation in the non-beating-heart lung donor (NBHLD). Chest.More infoabstractChest 1998;Suppl 4(Oct), vol 114
- Lick, S. D. (1997, April). Beta-adrenergic receptor desensitization is greater in "fast track" than in narcotic-based cardiac anesthetic. Anesthesiology.More infoabstract Anesthesiology 1997;87(No.3A):A89
- Lick, S. D. (1997, April). Noncatecholaminergic mediators released during cardiopulmonary bypass elicit more beta-adrenergic dysfunction than catecholamines. Anesthesiology.More infoabstractAnesthesiology 1997;87(No.3A)A88
- Lick, S. D. (1996, January). Ischemic Preconditioning and Postischemic Contractile Dysfunction in the Rabbit Heart (abstract). J Mol Cell Cardiol.More infoabstract J Mol Cell Cardiol 1996;28:a185
- Vertrees, R. A., Conti, V. R., Lick, S. D., Zwischenberger, J. B., McDaniel, L. B., & Shulman, G. (1996). Adverse effects of postoperative infusion of shed mediastinal blood. The Annals of thoracic surgery.More infoPostoperative infusion of shed mediastinal blood has been used in an effort to decrease blood usage after cardiac operations. Recent experience has suggested that this practice may actually lead to a delayed increase in bleeding.
- Lick, S. D. (1993, January). Bridge to Transplant With The Novacor Left Ventricular Assist System (LVAS) at the University of Arizona. American Society for Artificial Internal Organs.More infoASAIO abstracts, 1993; 39:30
- Lick, S. D. (1989, February). Recurrence or persistence. Surgery.More infoletter, commentSurgery, 1989; 106:578