Dr. Sam Zeraatian

    Perfusion Management – Technical Notes   Core Perfusion Strategy   •Full CPB with bicaval cannulation •Target DHCA at 18–20°C •Ensure excellent venous drainage •Maintain uniform cooling (ΔT <10°C)   ⸻   Cooling Phase   •Duration: 30–45 min •Strategy: Alpha-stat •Monitor: •NIRS (cerebral saturation) •Core vs peripheral temp gradient..

    Technical Challenges & Surgical Strategy Background •Aorto–pulmonary fistula is a rare but life-threatening complication •Common in redo cardiac surgery •Frequently associated with: •Prior aortic valve/root procedures •Infective endocarditis •Pseudoaneurysm rupture •Leads to: •Continuous left-to-right shunt •Pulmonary overcirculation •Progressive LV & RV dysfunction   ⸻    Objective   To..

    Heart Procurement and Placement on OCS – Stepwise Approach   I. Preoperative Preparation   1.Team Preparation •Confirm donor consent and organ allocation. •Communicate with recipient surgical team and perfusion/OCS team. •Confirm availability of all equipment: OCS device, cannulas, prime solutions, perfusate. 2.Donor Assessment •Review hemodynamic stability, echocardiography, coronary..

      1. Donor Identification •Identify a potential DCD donor (Maastricht category III or II in some systems). •Patient has devastating neurologic or systemic injury but does not meet brain death criteria. •Decision for withdrawal of life-sustaining therapy (WLST) is made independently of the transplant team.   ⸻  ..

A redo Bentall operation for right coronary artery (RCA) ostial insufficiency represents one of the most technically demanding scenarios in complex aortic root surgery. This condition typically arises from progressive ostial stenosis, kinking, pseudoaneurysm formation, or patch dehiscence following a prior composite valve–graft root replacement, leading to myocardial ischemia, ventricular..

Ex Vivo Lung Perfusion (EVLP) has become a key strategy to assess, recondition, and safely transplant lungs from DCD (Donation after Circulatory Death) donors, particularly because of warm ischemia exposure. Below is a practical, clinically oriented guide focused on how to use EVLP after DCD, with protocols and critical parameters..

An on-pump veno-arterial (VA) ECMO strategy allows safe stabilization and preparation of a lung-less patient while awaiting immediate implantation of the recipient graft. Following bilateral pneumonectomy, VA ECMO provides full cardiopulmonary support, maintaining systemic perfusion and oxygen delivery while unloading the right ventricle and preventing hemodynamic collapse. This approach enables..

LVAD Implantation in Pediatric Population inflow from LV and outflow to Ascending Aorta.   LVAD Implantation in the Pediatric Population   By Sam Zeraatiannejaddavani, MD   ⸻   A — Assessment & Indications   1. Clinical Indications •Refractory Stage D heart failure despite optimal medical therapy (NYHA IV / INTERMACS..

How to Prime an EVLP device from A to Z with back table LA and PA cuff srcuring and Dextran Priming as well connecting to EVLP.   Dr.Sam Zeraatian Nejad Davani,Cardiovascular and Transplant surgeon. Advanced Fellow of Thoracic Organs Transplantation Chicago Illinois.                ..

  Cardiopulmonary bypass is established following systemic heparinization to achieve an activated clotting time greater than four hundred and eighty seconds. Arterial cannulation is performed in the ascending aorta, while venous drainage is obtained using either bicaval cannulation or a single right atrial cannula, depending on exposure and surgeon preference...