Ethan Jackson, M.D.

All Publications

• Intra-cardiac Metastatic Melanoma Resulting in Near Complete Obstruction of the Left Ventricular Cavity Society of Cardiovascular Anesthesiologists Annual Meeting. Montreal, Quebec, Canada. Bartuska,, A., Han, L., Fielding-Singh, V., Jackson, E., Feng, T. 2025
• Which To Address First? A Case of a Type A Thoracic Aortic Dissection Complicated by Ischemic Stroke Society of Cardiovascular Anesthesiologists Annual Meeting. Montreal, Quebec, Canada. Barker, T., Jackson, E. 2025
• Factor Eight Inhibitor Bypass Activity use in cardiac surgery: A propensity matched analysis of safety outcomes. Anesthesiology Nicholas, J. A., Harrison, N., Chakraborty, D., Chang, A. L., Aghaeepour, N., Wirtz, K., Nielson, E., Parsons, C., Jackson, E., Panigrahi, A. K. 2024

  Abstract

  Bleeding during cardiac surgery may be refractory to standard interventions. Off-label use of Factor Eight Inhibitor Bypass Activity (FEIBA) has been described to treat such bleeding. However, reports of safety, particularly thromboembolic outcomes, show mixed results and reported cohorts have been small.Adult patients undergoing cardiac surgery on cardiopulmonary bypass between July 1, 2018 and June 30, 2023 at Stanford Hospital were reviewed (n=3335). Patients who received FEIBA to treat post-cardiopulmonary bypass bleeding were matched with those who did not by propensity scores in a 1:1 ratio using nearest neighbor matching (n= 352 per group). The primary outcome was a composite outcome of thromboembolic complications including any one of deep vein thrombosis (DVT), pulmonary embolism (PE), unplanned coronary artery intervention, ischemic stroke, and acute limb ischemia, in the postoperative period. Secondary outcomes included renal failure, reoperation, postoperative transfusion, ICU length of stay (LOS), and 30-day mortality.704 encounters were included in our propensity matched analysis. The mean dose of FEIBA administered was 7.3 ±5.5 units/kg. In propensity matched multivariate logistic regression models there was no statistically significant difference in odds ratios for thromboembolic outcomes, ICU LOS, or mortality. Patients who received >750 units of FEIBA had an increased odds ratio for acute renal failure (OR 4.14; 95% CI 1.61 to 10.36, p <0.001). In multivariate linear regression, patients receiving FEIBA were transfused more plasma and cryoprecipitate postoperatively. However, only the dose range of 501-750 units was associated with an increase in transfusion of RBCs (β 2.73; 95% CI 0.68 to 4.78; p=0.009), and platelets (β 1.74; 95% CI 0.85 to 2.63; p <0.001).Low dose FEIBA administration during cardiac surgery does not increase risk of thromboembolic events, ICU LOS, or mortality in a propensity matched cohort. Higher doses were associated with increased acute renal failure and postoperative transfusion. Further studies are required to establish the efficacy of activated factor concentrates to treat refractory bleeding during cardiac surgery.

  View details for DOI 10.1097/ALN.0000000000005208

  View details for PubMedID 39186670

• Uncommon presentations of type A quadricuspid aortic valve in the Septuagenarian. Journal of cardiothoracic surgery Choi, P., Paulsen, M., Lin, Y., Moskalik, W., Ji, A., Jackson, E., Malik, S., Burton, E., Woo, Y. J., Burdon, T. 2024; 19 (1): 301

  Abstract

  Quadricuspid aortic valve (QAV) is a rare congenital anomaly characterized by the presence of four cusps instead of the usual three. It is estimated to occur in less than 0.05% of the population, with Type A (four equal-sized leaflets) accounting for roughly 30% of QAV subtypes. Based on limited clinical series, the usual presentation is progressive aortic valve regurgitation (AR) with symptoms occurring in the fourth to sixth decade of life. Severe aortic valve stenosis (AS) and acute AR are very uncommon.We describe two cases of Type A QAV in patients who remained asymptomatic until their seventies with very uncommon presentations: one with severe AS and one with acute, severe AR and flail leaflet. In Case A, a 72-year-old patient with history of moderate AS presents to clinic with progressive exertional dyspnea. During work-up for transcatheter vs. surgical replacement pre-operative computed tomography angiogram (CTA) reveals a quadricuspid aortic valve with severe AS, and the patient undergoes surgical aortic valve replacement. Pre-discharge transthoracic echocardiography (TTE) shows good prosthetic valve function with no gradient or regurgitation. In Case B, a 76-year-old patient is intubated upon arrival to the hospital for acute desaturation, found to have wide open AR on catheterization, and transferred for emergent intervention. Intraoperative TEE reveals QAV with flail leaflet and severe AR. Repair is considered but deferred ultimately due to emergent nature. Post-operative TTE demonstrates good prosthetic valve function with no regurgitation and normal biventricular function.QAV can present as progressive severe AS and acute AR, with symptoms first occurring in the seventh decade of life. The optimal treatment for QAV remains uncertain. Although aortic valve repair or transcatheter option may be feasible in some patients, aortic valve replacement remains a tenable option.

  View details for DOI 10.1186/s13019-024-02696-w

  View details for PubMedID 38812010

  View details for PubMedCentralID PMC11134947

• Management of Major Arterial Vascular Diseases in Pregnancy - Pulmonary Arterial Hypertension and Thoracic Aortopathies Obstetric Anesthesia and Uncommon Disorders Jackson, E., Romfh, A., Sung, Y., Bodmer, N. Cambridge University Press. 2024; Third Edition
• Safety of FEIBA Administration for Cardiac Surgery. Anesthesiology (Editor’s Choice Video) Anesthesiology. Associated with Volume 141, Issue 6: 1051-1064. doi; 10.1097/ALN.0000000000005208. Nichols, J., Harrison, N., Chakraborty, D., Chang, A., Aghaeepour, N., Wirtz, K., Nielson, E., Parsons, C., Jackson, E., Panigrahi, A. 2024
• Anesthetic Management of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) During Cesarean Section Society of Cardiovascular Anesthesiologists Annual Meeting. Miller, S., Jackson, E. 2024
• Preserving Right Ventricular Assist Device (RVAD) & Veno-Arterial Extracorporeal (VA ECMO) Mechanical Support Patency in Tenuous Decannulation Patients Using Novel Heparinized Saline Infusions - A Case Series Society of Cardiovascular Anesthesiologists Annual Meeting. Perez, R., O'Laco, K., Jackson, E. 2024
• Vascular Ehlers-Danlos Syndrome in Pregnancy: Anesthetic Management of High-Risk Cesarean Delivery Society of Cardiovascular Anesthesiologists Annual Meeting. Nihn, A., Jackson, E. 2024
• Prophylactic Use of Peripheral VA ECMO in a Patient with Compressive IVC Syndrome & Refractory Hypoxemia Undergoing Massive Left Lung Solitary Fibrous Tumor Resection Society of Cardiovascular Anesthesiologists Annual Meeting. Goodman , J., Jackson, E., Kiwakyou, L., Elliott, I., Guenthart, B. 2024
• The Year in Graduate Medical Education: Selected Highlights from 2022 - (1)Three-Dimensional Transesophageal Echocardiography Simulator: New Learning Tool for Advanced Imaging Techniques Journal of Cardiothoracic and Vascular Anesthesia Patel, S., Notarianni, A., Martin, A., Tsai, A., Pulton, D., Linganna, R., Patel, P., Waldron, N., Nimma, S., Bodmer, N., Kothari, P., Jackson, E., Gupta, R., Roberts, M., Feinman, J. 2023
• Strategic Peripheral VVA ECMO Rescue for Refractory VV ECMO Hypoxemia in the Setting of Bi-Caval Stenosis Society of Cardiovascular Anesthesiologists Annual Meeting. Hermon, A., Jackson, E. 2023
• First-in-human Beating-Heart Transplant Journal of Thoracic and Cardiovascular Surgery Techniques Krishnan, A., Kasinpila, P., Wang, H., Ruaengsri, C., Shudo, Y., Jackson, E., Woo, Y. 2023
• Strategic Mechanical Circulatory Support Cesarean Section Management of a Left Ventricular Noncompaction Cardiomyopathy Parturient in Cardiogenic Shock Society of Cardiovascular Anesthesiologists Annual Meeting. Wang, J., Jackson, E. 2023
• Previously Undiagnosed Congenital Cardiac Anomalies in an Adult with Trisomy 21 Society of Cardiovascular Anesthesiologists Annual Meeting. Kiwakyou, L., Zeng, A., Jackson, E., Peterson, A. 2023
• The Year in Graduate Medical Education: Selected Highlights from 2021 - (1) Transport and Retrieval on Extracorporeal Membrane Oxygenation (ECMO): Setup and Activities of an Immersive Transport and Retrieval on ECMO Workshop & (2) Efficacy of a Point-of-Care Transthoracic Echocardiography Workshop for Medical Students Journal of Cardiothoracic and Vascular Anesthesia Patel, M., Patel, P., Martin, A., Tsai, A., Linganna, R., Ghofaily, L., Notarianni, A., Allen, W., Buric, D., Bodmer, N., Kothari, P., Jackson, E., Feinman, J. 2022
• (Venovenous ECMO) Circuit Chatter After A Cesarean Delivery Society of Cardiovascular Anesthesiologists Annual Meeting. Ma, C., Madhok, J., Jackson, E. 2022
• First lung and kidney multi-organ transplant following COVID-19 Infection. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Guenthart, B. A., Krishnan, A., Alassar, A., Madhok, J., Kakol, M., Miller, S., Cole, S. P., Rao, V. K., Acero, N. M., Hill, C. C., Cheung, C., Jackson, E. C., Feinstein, I., Tsai, A. H., Mooney, J. J., Pham, T., Elliott, I. A., Liou, D. Z., La Francesca, S., Shudo, Y., Hiesinger, W., MacArthur, J. W., Brar, N., Berry, G. J., McCarra, M. B., Desai, T. J., Dhillon, G. S., Woo, Y. J. 2021

  Abstract

  As the world responds to the global crisis of the COVID-19 pandemic an increasing number of patients are experiencing increased morbidity as a result of multi-organ involvement. Of these, a small proportion will progress to end-stage lung disease, become dialysis dependent, or both. Herein, we describe the first reported case of a successful combined lung and kidney transplantation in a patient with COVID-19. Lung transplantation, isolated or combined with other organs, is feasible and should be considered for select patients impacted by this deadly disease.

  View details for DOI 10.1016/j.healun.2021.02.015

  View details for PubMedID 34059432

• Prolonged Venovenous Extracorporeal Membrane Oxygenation (VV ECMO) as a Bridge to Multi-Organ Transplantation for Severe Coronavirus Disease 2019. Virtual Society of Cardiovascular Anesthesia Thoracic Anesthesia Symposium. Madhok, J., Jackson, E., Tsai, A., Guenthart, B. 2021
• Left Ventricular True Aneurysm Presenting as Epigastric Pain and Fevers. Society of Cardiovascular Anesthesiologists Annual Meeting. Jackson, E., Leong, J. 2020
• Case Report of an Awake Craniotomy in a Patient With Eisenmenger Syndrome. A&A practice Heifets, B. D., Crawford, E., Jackson, E., Brodt, J., Jaffe, R. A., Burbridge, M. A. 2018; 10 (9): 219-222

  Abstract

  We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis.

  View details for DOI 10.1213/XAA.0000000000000664

  View details for PubMedID 29708913

  View details for PubMedCentralID PMC6309536

• Anesthetic Management of a Redo-Sternotomy Patient with a Sternal Osteophyte Penetrating the Ascending Thoracic Aorta (“A Case of the Otomies”) Society of Cardiovascular Anesthesiologists Annual Meeting Sheriffdeen, R., Oakes, D., Jackson, E. 2018
• Case Report of an Awake Craniotomy in a Patient With Eisenmenger Syndrome. A & A case reports Heifets, B. D., Crawford, E. n., Jackson, E. n., Brodt, J. n., Jaffe, R. A., Burbridge, M. A. 2017

  Abstract

  We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis.

  View details for DOI 10.1213/XAA.0000000000000664

  View details for PubMedID 29135526

• Pulmonary Hypertensive Crisis Following Ethanol Sclerotherapy for a Complex Vascular Malformation The Journal of Perinatology Cordero-Schmidt, G., Wallenstein, M., Ozen, M., Shah, N., Jackson, E., Hovsepian, D., Palma, J. 2014; 34 (9): 713-715

  View details for DOI 10.1038/jp.2014.88

• Anesthetic Management of Cardiac Biopsy-Induced Severe Tricuspid Valve Regurgitation in a Recent Heart Transplant Recipient (Complex Case) Society of Cardiovascular Anesthesiologists Annual Meeting Powers, A., Jackson, E. 2013
• Acute Alcohol Toxicity in a Neonate Society for Pediatric Anesthesiology / American Academy of Pediatrics Annual Meeting Laughlin, M., Jackson, E. 2013
• Severe Lung Injury Following Unroofed Coronary Sinus Repair in a Patient with Undetected Subtotal Cor Triatriatum Society of Cardiovascular Anesthesiologists Annual Meeting Bain, S., Kuan, C., Jackson, E. 2013
• Role of ketamine in the management of pulmonary hypertension and right ventricular failure. Journal of cardiothoracic and vascular anesthesia Maxwell, B. G., Jackson, E. 2012; 26 (3): e24-5

  View details for DOI 10.1053/j.jvca.2012.01.004

  View details for PubMedID 22361483

• A method of rapid robust respiratory synchronization for MRI PEDIATRIC RADIOLOGY Vasanawala, S. S., Jackson, E. 2010; 40 (10): 1690-1692

  Abstract

  Respiratory motion degrades MRI exams. Adequate detection of respiratory motion with pneumatic respiratory belts in small children is challenging and time-consuming.

  View details for DOI 10.1007/s00247-010-1755-y

  View details for Web of Science ID 000281907100014

  View details for PubMedID 20567966

  View details for PubMedCentralID PMC3004967

• The effects of dexmedetomidine on cardiac electrophysiology in children ANESTHESIA AND ANALGESIA Hammer, G. B., Drover, D. R., Cao, H., Jackson, E., Williams, G. D., Ramamoorthy, C., Van Hare, G. F., Niksch, A., Dubin, A. M. 2008; 106 (1): 79-83

  Abstract

  Dexmedetomidine (DEX) is an alpha2-adrenergic agonist that is approved by the Food and Drug Administration for short-term (<24 h) sedation in adults. It is not approved for use in children. Nevertheless, the use of DEX for sedation and anesthesia in infants and children appears to be increasing. There are some concerns regarding the hemodynamic effects of the drug, including bradycardia, hypertension, and hypotension. No data regarding the effects of DEX on the cardiac conduction system are available. We therefore aimed to characterize the effects of DEX on cardiac conduction in pediatric patients.Twelve children between the ages of 5 and 17 yr undergoing electrophysiology study and ablation of supraventricular accessory pathways had hemodynamic and cardiac electrophysiologic variables measured before and during administration of DEX (1 microg/kg IV over 10 min followed by a 10-min continuous infusion of 0.7 microg x kg(-1) x h(-1)).Heart rate decreased while arterial blood pressure increased significantly after DEX administration. Sinus node function was significantly affected, as evidenced by an increase in sinus cycle length and sinus node recovery time. Atrioventricular nodal function was also depressed, as evidenced by Wenckeback cycle length prolongation and prolongation of PR interval.DEX significantly depressed sinus and atrioventricular nodal function in pediatric patients. Heart rate decreased and arterial blood pressure increased during administration of DEX. The use of DEX may not be desirable during electrophysiology study and may be associated with adverse effects in patients at risk for bradycardia or atrioventricular nodal block.

  View details for DOI 10.1213/01.ane.0000297421.92857.4e

  View details for PubMedID 18165557

• Management of Parturient Congenital Heart Disease (in chapter entitled Structural Heart Disease in Pregnant Women) Obstetric Anesthesia and Uncommon Disorders Carvalho, B., Jackson, E. Cambridge University Press. 2008; Second Edition
• Postoperative Respiratory Depression in Children Anesthetized with Remifentanil With or without Spinal Anesthesia for Open Heart Surgery Anesthesiology Hammer GB, Drover D, Jackson E, Kamra K, Evans DA 2002: 96: A1223
• Comparison of Remifentanil With or Without Spinal Anesthesia for Children Undergoing Open Heart Surgery Anesthesiology Hammer GB, Drover D, Jackson E, Kamra K, Evans DA 2002: 96: A1222
• The Effect of Arteriovenous Malformations on the Distribution of Intracerebral Arterial Pressures American Journal of Neuroradiology Fogarty-Mack, P., Pile-Spellman, J., Hacien-Bey, L., Jackson, E., Young, W. 1996; 17: 1443-1449