Division of Cardiothoracic Anesthesia - Department of Anesthesiology
G. Burkhard Mackensen, MD

Division of Cardiothoracic Anesthesia

 

G. Burkhard Mackensen, MD, PhD, FASE

G. Burkhard Mackensen, MDDr. G. Burkhard Mackensen received his medical degree from the University of Hamburg in Germany before he attended the Department of Anesthesiology at the Technical University Munich for a residency in Anesthesiology and a fellowship in Intensive Care Medicine. He first came to Duke as a postdoctoral Research Fellow in 1997 and continued as a Fellow in Cardiothoracic Anesthesiology in 1998 after which he returned in 2000 to Germany to carry on research in the Cardiopulmonary Bypass Research Laboratory at the Technical University Munich. In 2004, Dr. Mackensen has returned to Duke as Faculty, where he now serves as Associate Professor of Anesthesiology and Director of the Cardiopulmonary Bypass Research Laboratories.

Dr. Mackensen’s major research interests focus on the investigation of mechanisms and potential strategies for therapy related to cerebral injury following CPB and cardiac surgery. For the preclinical investigation of these topics, a rat model of cardiopulmonary bypass that allows the long-term recovery of the animals is utilized. In addition, he and his colleagues are expanding work with a newly developed model of deep hypothermic cardiac arrest (DHCA) in the rat. This area (i.e. DHCA) has long been lacking a small animal model that allows long-term testing and evaluation of neurocognitive function; this novel model will promote numerous lines of research. Both models (DHCA and CPB) serve to investigate improved modes of anticoagulation during CPB as well as renal impairment associated with CPB/DHCA. Dr. Mackensen is also interested in the neurobehavioral testing of rodents and has been involved in the adaptation of the Hole-board test for the use in animals with cerebral injury. This test represents a more meaningful neurocognitive test compared to the Morris water maze, and includes numerous cognitive outcome parameters. In the future, Dr. Mackensen plans to focus on the inflammatory response following CPB, with links to cerebral gene and protein expression, proteomics and possible therapeutic interventions.

In 2005, Dr. Mackensen received his Ph.D. from the Technical University in Munich with his thesis: “Experimental advances for pharmacologic neuroprotection after cerebral ischemia: special role of volatile anesthetics, catalytic antioxidants and other drugs.” In 2006, he was elected Fellow of the American Society of Echocardiography and is a member of both, the American Society of Echocardiography’s Council for Intraoperative Echocardiography and the International Task Force.

Grants

  1. Cross-Species Analysis of Myocardial Susceptibility to Perioperative Stress
    Principal Investigator: Mihai Podgoreanu, MD
    NIHLB 1 R01 ES015719-01
    Grant period: 09/07-08/11
    Role: Co-investigator, 20% effort
  2. Neuroprotection of pH Sensitive NMDAR Antagonists in Cardiopulmonary Bypass Surgery
    PI: Scott Myers PhD NIH/NINDS 2 R43 NS57917-01
    Grant period: 01/08-06/30/07
    Role: Principal Investigator on Subcontract
  3. Aptamer against Factor IX during ex vivo cardiopulmonary bypass Regado Biosciences.
  4. Deutsche Forschungsgemeinschaft (German Research Foundation) 344/3-1: “Reduction of Neurologic Complications Following Cardiac Surgery.” Co-Principal Investigator. 01/01/02 -12/31/04.
  5. AGA Linde Healthcare, Sweden: “Xenon in Cardiopulmonary Bypass.” Principal Investigator. 01/01/03 12/31/04.
  6. Society of Cardiovascular Anesthesiologists/Ischemia Research and Education
  7. Foundation: “The Effect of Hematocrit on the Inflammatory Response Following Cardiopulmonary Bypass.” Co-investigator and Mentor. 07/01/03-06/30/05.

Peer-Reviewed Manuscripts

  1. de Lange F, Yoshitani K, Proia AD, Mackensen GB, Grocott HP. Perfluorocarbon administration during cardiopulmonary bypass in rats: An inflammatory link to adverse outcome? Anesth Analg 2008;106:24-31.
  2. Welsby I, Jones R, Pylman J, Mark JB, Brudney CS, Phillips-Bute B, Mathew JP, Campbell ML, Stafford-Smith M and the Cardiothoracic Anesthesiology Research Endeavors (CARE) Investigators of the Duke Heart Center. ABO blood group and bleeding after coronary artery bypass surgery. Blood Coagulation & Fibrinolysis 2007;18:781-785.
  3. Nicoara A, Mackensen GB, Podgoreanu MV, Milano CA, Mathew JP. Malpositioned left ventricular assist device cannula: Diagnosis and management with transesophagea echocardiography guidance. Anesth Analg 2007; 105:1574-1576.
  4. Jungwirth B, Kellermann K, Blobner M, Schmehl W, Kochs EF, Mackensen GB. Cerebral air emboli differentially alter outcome after cardiopulmonary bypass in rats compared with normal circulation. Anesthesiology 2007;107:768-775.
  5. Mathew JP, Mackensen GB, Phillips-Bute B, Stafford-Smith M, Podgoreanu MV, Grocott HP, Hill SE, Smith PK, Blumenthal JA, Reves JG, Newman MF for the Neurologic Outcome Research Group (NORG) of the Duke Heart Center. Effects of extreme hemodilution during cardiac surgery on cognitive function in the elderly. Anesthesiology 2007;107:577-584.
  6. Mathew JP, Podgoreanu MV, Grocott HP, White WD, Morris RW, Stafford-Smith M, Mackensen GB, Rinder CS, Blumenthal JA, Schwinn DA, Newman MF, for the Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team. Genetic variants in Pselectin and C-reactive protein influence susceptibility to cognitive decline after cardiac surgery. J Am Coll Cardiol 2007;49:1934-1942.
  7. Swaminathan M, Mackensen GB, Podgoreanu MV, McCann RL, Mathew JP, Hughes GC. Spontaneous echocardiographic contrast indicating successful endoleak management. Anesth Analg 2007;104:1037-1039.
  8. Swaminathan M, Grocott HP, Mackensen GB, Podgoreanu MV, Glower DD, Mathew JP. The “sandblasting” effect of aortic cannula on arch atheroma during cardiopulmonary bypass. Anesth Analg 2007;104:1350-1351.
  9. Welsby IJ, Jones WL, Arepally G, De Lange F, Yoshitani K, Phillips-Bute B, Grocott HP, Becker R, Mackensen GB. Effect of combined anticoagulation using heparin and bivalirudin on the hemostatic and inflammatory responses to cardiopulmonary bypass in the rat. Anesthesiology 2007;16:295-301.
  10. Yoshitani K, de Lange F, Ma Q, Grocott HP, Mackensen GB. Reduction in air bubble size using perfluorocarbons during cardiopulmonary bypass in the rat. Anesth Analg 2006;103:1089-1093.
  11. Newman MF, Mathew JP, Grocott HP, Mackensen GB, Monk T, Welsh-Bohmer KA, Laskowitz D, Mark DB, Blumenthal JA for the Neurologic Outcome Research Group. Central nervous system injury after cardiac surgery. Lancet 2006;9536:694-703.
  12. Izrailtyan I, Clark J, Swaminathan M, Podgoreanu MV, Mackensen GB, Davis RD, Mathew JP. Case report: optimizing intraoperative detection of pulmonary embolism using contrast-enhanced echocardiography. Can J Anaesth 2006;53:711-715.
  13. Dieleman JM, de Lange F, Houston RJF, Biessels G-J, Bär PR, Mackensen GB, Grocott HP, Kalkman CJ. Cardiopulmonary bypass and long-term neurocognitive dysfunction in the rat. Life Sci 2006;77:551-558.
  14. Podgoreanu MV, White WD, Morris RW, Mathew JP, Stafford-Smith M, Welsby IJ, Grocott HP, Milano CA, Newman MF, Schwinn DA for the Perioperative Genetics and Safety Outcomes (PEGASUS) Investigative Team. Inflammatory gene polymorphisms and risk of postoperative myocardial infarction after cardiac surgery. Circulation 2006;114:I275-281.
  15. Jungwirth B, Gordan ML, Blobner M, Schmehl W, Kochs EF, Mackensen GB. Xenon impairs neurocognitive and histologic outcome after cardiopulmonary bypass combined with cerebral air embolism in rats. Anesthesiology 2006;104:770-776.
  16. Phillips-Bute B, Mathew JP, Blumenthal JA, Grocott HP, Laskowitz DT, Jones RH, Mark DB, Newman MF for the Neurologic Outcome Research Group (NORG). Association of neurocognitive function and quality of life one year after coronary artery bypass graft (CABG) surgery. Psychosom Med 206;68:369-375.
  17. Jungwirth B, Mackensen GB, Blobner M, Neff F, Reichart B, Kochs EF, Nollert G. Neurologic outcome following cardiopulmonary bypass with deep hypothermic circulatory arrest in rats: Description of a new model. J Thorac Cardiovasc Surg 2006;131:805-812.
  18. Moretti EW, Morris RW, Podgoreanu M, Schwinn DA, Newman MF, Bennett E, Moulin VG, Mba UU, Laskowitz DT, the Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team. APOE polymorphism is associated with risk of severe sepsis in surgical patients. Crit Care Med 2005;33:2521-2526.
  19. Grocott HP, White WD, Morris RW, Podgoreanu M, Mathew JP, Nielsen DM, Schwinn DA, Newman MF for the Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team. Genetic polymorphisms and the risk of stroke after cardiac surgery. Stroke 2005;36:1854-1858.
  20. Stafford-Smith M, Podgoreanu M, Swaminathan M, Phillips-Bute B, Mathew JP, Hauser EH, Winn MP, Milano C, Nielsen DM, Smith M, Morris R, Newman MF, Schwinn DA, and Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team. Association of genetic polymorphisms with risk of renal injury after coronary bypass graft surgery. Am J Kidney Dis 2005;45:519-530.
  21. Schambra UB, Mackensen GB, Stafford-Smith M, Haines DE, Schwinn DA. Neuron specific alpha-adrenergic receptor expression in human cerebellum: Implications for emerging cerebellar roles in neurologic disease. Neuroscience 2005;135:507-523.
  22. Welsby IJ, Podgoreanu MV, Phillips-Bute B, Mathew JP, Smith PK, Newman MF, Schwinn DA, Stafford-Smith M and Perioperative Genetics and Safety Outcomes Study (PEGASUS) Investigative Team. Genetic factors contribute to bleeding after cardiac surgery. J Thromb Haemost 2005;3:1206-1212
  23. Mathew JP, Grocott HP, McCurdy II JR, Ti LK, Davis RD, Laskowitz DT, Podgoreanu MV, Swaminathan M, Lynch J, Stafford-Smith M, White WD, Newman MF and the Neurological Outcome Research Group (NORG) of the Duke Heart Center. Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2005; 19:294-299.
  24. Sulzer CF, Mackensen GB, Grocott HP. Con: Methylprednisolone is not indicated for patients during cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2005;19:255-258.
  25. Stafford-Smith M, Lefrak EA, Qazi AG, Welsby IJ, Barber L, Hoeft A, Dorenbaum A, Mathias J, Rochon JJ, Newman MF and members of the Global Perioperative Research Organization (GPRO). Efficacy and safety of heparinase I versus protamine in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass. Anesthesiology 2005; 103:229-240.
  26. Bar-Yosef S, Anders M, Mackensen GB, Ti LK, Mathew JP, Phillips-Bute B, Messier RH, Grocott HP. Aortic atheroma burden and cognitive dysfunction following coronary artery bypass graft surgery. Ann Thorac Surg 2004;78:1556-1563.
  27. Mackensen GB, Swaminathan M, Ti LK, Grocott HP, Phillips-Bute B, Mathew JP, Newman MF, Milano CM, Stafford-Smith M, an the Perioperative Outcomes Research Group and C.A.R.E. Investigators of Duke Heart Center. Preliminary report on the interaction of apolipoprotein E polymorphism with aortic atherosclerosis and acute nephropathy after CABG surgery. Ann Thorac Surg 2004;78:520-526.
  28. Mathew JP, Grocott HP, Phillips-Bute B, Stafford-Smith M, Laskowitz DT, Rossignol D, Blumenthal JA, Newman MF, and Neurological Outcome Research Group and C.A.R.E. Investigators of Duke Heart Center. Lower endotoxin immunity predicts increased cognitive dysfunction in elderly patients after cardiac surgery. Stroke 2003;34:508-513.
  29. Mackensen GB, Ti LK, Phillips-Bute BG, Mathew JP, Newman MF, Grocott HP and the Neurologic Outcome Research Group (NORG): Cerebral Embolization During Cardiac Surgery: The Impact of Aortic Atheroma Burden. Br J Anaesth 2003;91:656-661.
  30. Ti LK, Mackensen GB, Grocott HP, Laskowitz DT, Phillips-Bute B, Milano CA, Hilton AK, Newman MF, Mathew JP and the Neurological Outcome Research Group: Apolipoprotein E4 increases aortic atheroma burden in cardiac surgical patients. J Thorac Cardiovasc Surg 2003;125:211-213.
  31. Djaiani GN, McCreath BJ, Ti LK, Mackensen GB, Podgorneau M, Philips-Bute B, Mathew J: Mitral flow propagation velocity identifies patients with abnormal diastolic function during coronary artery bypass graft surgery. Anesth Analg 2002;95:524-530.
  32. Stanley TO, Mackensen GB, Grocott HP, White WD, Blumenthal JA, Laskowitz DT, Landolfo KP, Reves JG, Mathew JP, Newman MF and the Neurologic Outcome Research Group, and the CARE Investigators of the Duke Heart Center. The impact of postoperative atrial fibrillation on neurocognitiv e outcome after coronary artery bypass graft surgery. Anesth Analg 2002;94:290-295.
  33. Wainright MS, Sheng H, Sato Y, Mackensen GB, Steffen RP, Pearlstein RD, Grocott HP, Warner DS: Pharmacologic correction of hypothermic P50 shift does not alter outcome after transient focal cerebral ischemia in rats. Am J Physiol Heart Circ Physiol 2002;282:H1863-H1870.
  34. Grocott HP, Mackensen GB, Grigore AM, Mathew J, Reves JG, Phillips-Bute B, Smith PK, Newman MF: Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery. Stroke 2002;33:537-541.
  35. Mackensen GB, Sato Y, Nellgård B, Pineda J, Newman MF, Warner DS, Grocott HP: Cardiopulmonary bypass induces neurologic and neurocognitive dysfunction in the rat. Anesthesiology 2001;95:1485-1492.
  36. Ti LK, Mathew JP, Mackensen GB, Grocott GP, White WD, Reves JG, Newman MF: Effect of Apolipoprotein E genotype on cerebral autoregulation during cardiopulmonary bypass. Stroke 2001;32:1514-1519.
  37. Newman MF, Kirchner JL, Phillips-Bute B, Gaver V, Grocott H, Jones RH, Mark DB, Reves JG, Blumenthal JA for the Neurologic Outcome Research Group and C.A.R.E. Investigators of the Duke Heart Center. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med 2001;344:395-402.
  38. Mackensen GB, Patel M, Sheng H, Calvi C, Batinic-Haberle I, Day BJ, Liang LP, Fridovich I, Crapo JD, Pearlstein RD, Warner DS: Neuroprotection from delayed post-ischemic administration of a metalloporphyrin catalytic antioxidant. J Neurosci 2001;21:4582-4592.
  39. Bainbridge D, Mackensen GB, Newman MF, Landolfo K, Grocott HP: Off-pump coronary artery bypass surgery in a patient with C1 esterase inhibitor deficiency. Anesthesiology 2001;95:795-796.
  40. Grocott HP, Mackensen GB, Newman MF, Warner DS: Neurologic injury during cardiopulmonary bypass in the rat. Perfusion 2001;16:75-81.
  41. Kilts JD, Gerhardt MA, Richardson MD, Sreeram G, Mackensen GB, Grocott HP, White WD, Davis RD, Newman MF, Reves JG, Schwinn DA, Kwatra MM: Beta(2) adrenergic and several other G protein-coupled receptors in human atrial membranes activate both G(s) and G(i). Circ Res 2000;87:705-709
  42. Nellgård B, Mackensen GB, Massey G, Pearlstein R, Warner DS: The effects of anesthetics on stress responses to forebrain ischemia and reperfusion in the rat. Anesth Analg 2000;91:145-151.
  43. Mackensen GB, Nellgård B, Kudo M, Sheng H, Pearlstein RD, Warner DS: Peri ischemic cerebral blood flow (CBF) does not explain beneficial effects of isoflurane on outcome from near-complete forebrain ischemia in rats. Anesthesiology 2000;93:1102-1106.
  44. Wellons JC, Sheng H, Laskowitz DT, Mackensen GB, Pearlstein RD, Warner DS: A comparison of strain-related susceptibility in two murine recovery models of global cerebral ischemia. Brain Res 2000;868:14-21.
  45. Nellgård B, Mackensen GB, Pineda J, Wellons JC 3rd, Pearlstein R, Warner DS: Anesthetic effects on cerebral metabolic rate predict histologic outcome from near complete forebrain ischemia in the rat. Anesthesiology 2000;93:431-436.
  46. Sheng H, Kudo M, Mackensen GB, Pearlstein RD, Crapo JD, Warner DS: Mice overexpressing extracellular superoxide dismutase have increased resistance to global cerebral ischemia. Exp Neurol 2000;163:392-398.
  47. Mackensen GB, Grocott HP, Stafford Smith M: An interesting finding during transesophageal echocardiographic assessment of the mitral valve. J Cardiothorac Vasc Anesth 2000;14:227-228.
  48. Mackensen GB, Nellgård B, Sarraf-Yazdi S, Dexter F, Steffen RP, Grocott HP, Warner DS: Postischemic RSR13 amplifies effects of dizocilpine on outcome from focal cerebral ischemia in the rat. Brain Res 2000;853:15-21.
  49. Nellgård B, Miura Y, Mackensen GB, Sarraf-Yazdi S, Pearlstein R, Warner DS: Preischemic depletion of brain norepinephrine decreases infarct size in normothermic rats exposed to transient focal cerebral ischemia. Neurosci Lett 1999;275:167-170.
  50. Nellgård B, Miura Y, Mackensen GB, Pearlstein R, Warner DS: Effect of intracerebral norepinephrine depletion on outcome from severe forebrain ischemia in the rat. Brain Res 1999;847:262-269.
  51. Sheng H, Laskowitz DT, Mackensen GB, Kudo M, Pearlstein RD, Warner DS: Apolipoprotein E deficiency worsens outcome from global cerebral ischemia in the mouse. Stroke 1999;30:1118-1124.
  52. Miura Y, Mackensen GB, Nellgård B, Pearlstein R, Warner DS: Effects of isoflurane, ketamine, and fentanyl/N2O on concentrations of brain and plasma catecholamines during nearcomplete cerebral ischemia in the rat. Anesth Analg 1999;88:787-792.
  53. Grocott HP, Sheng H, Miura Y, Sarraf-Yazdi S, Mackensen GB, Pearlstein RD, Warner DS: The effects of aprotinin, a serine protease inhibitor, on outcome from cerebral ischemia in the rat. Anesth Analg 1999;88:1-7.
  54. Mackensen GB, Nellgård B, Miura Y, Chu CT, Dexter F, Pearlstein R, Warner DS: Sympathetic ganglionic blockade masks positive effect of isoflurane on histologic outcome from near-complete ischemia in rats. Anesthesiology 1999;90:873-881.
  55. von Schrenck T, Mackensen B, Mende U, Schmitz W, Sievers J, Mirau S, Raedler A, Greten H: Signal transduction pathway of muscarinic receptors mediating gallbladder contraction. Naunyn-Schmiedeberg’s Archives of Pharmacology 1994;349:346-354.

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