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Personal History
I graduated from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania. I subsequently did my residency in anesthesiology at St. Lukes-Roosevelt Hospital Center, Columbia University, in New York City which was followed by two years of fellowship training in Cardiothoracic and Vascular Anesthesia at Duke University. During my second year at Duke, I obtained a Masters Degree in Health Sciences and Clinical Research. After completion of my fellowship, I worked for seven years at the Texas Heart Institute where I gained clinical expertise in cardiac, vascular and thoracic anesthesiology and I served as one of the Operating Room Directors. I have developed a Cardiovascular Anesthesia Echocardiography program at the Texas Heart Institute. Under my supervision, over 22 cardiovascular anesthesiology fellows and staff members became certified by the National Board of Echocardiography. After Texas Heart Institute, I worked at the Mayo Clinic in Arizona where I served as Curriculum Director for residents on the cardiac anesthesia rotation. I joined the Department as Director of Division of Cardiothoracic and Vascular Anesthesiology in 2010.
My research areas of interest in neuroprotection and in heart failure have been supported by several local, regional and industry grants.
Research Interests
One of my areas of interest is related to myocardial structural changes in end-stage heart failure and to the impact of ventricular unloading, provided by left ventricular assist devices (LVADs), on alpha and beta adrenoreceptors density and distribution. Following ventricular decompression, by probing of the adrenoreceptors with fluorescent probes, we found a profound increase in betaAR number, a slight increase in alpha AR number and a change from a "clumped" pattern of receptor distribution to a very homogeneous appearance throughout the tissue samples. Moreover, myofibrils from pre-LVAD samples (Panels A and B) showed a more disorganized and disrupted pattern associated with a perivascular distribution of ARs. In contrast, paired post-LVAD tissue samples (Panels C and D) revealed long, intact and organized myofibrils with a homogenous intra-myocytic distribution of AR. An overall improvement in physical state of the myocardial tissue was noted in post-LVAD samples.
Another area of interest is related to neuroprotection during cardiac surgery. We found that mild hypothermia and slow rewarming rate is associated with better neurocognitive outcomes particularly in diabetic cardiac surgical patients.
Clinical Speciality
Cardiothoracic and Vascular Anesthesiology
Perioperative Transesophageal Echocardiography
Publications
Peer-Reviewed Journal Articles
Grigore AM, Brusco L Jr, Kuroda M, Koorn R. Laudanosine and atracurium levels in a patient receiving long term atracurium infusion. Critical Care Medicine 1998;26:180-183.
Grigore AM, Brusco L Jr. Temperature regulation and manipulation during surgery. Progress in Anesthesiology 1998;XII:159-176.
Grigore AM, Castro J, Swistel D, Thys DM. Nicardipine infusion for the prevention of radial artery spasm during myocardial revascularization. J Cardiothorac Vasc Anesth 1998;12:556-557.
Newman MF, Laskowitz DT, Saunders AM, Grigore AM, Grocott HP. Genetic predictors of perioperative neurologic and neuropsychological injury and recovery. Seminars in Cardiothorac Vasc Anesth 1999;3:34-46.
Grigore AM, Castro J, Swistel D, Thys DM. Nicardipine infusion for radial artery spasm: A cautionary note (response). J Cardiothorac Vasc Anesth 1999;13:510.
Grigore AM, Grocott HP. Pro: Epiaortic scanning should be used routinely during cardiac surgery. J Cardiothorac Vasc Anesth 2000;14:87-90.
Grigore AM, Mathew JP. Con: Magnesium should be administered to all CABG patients undergoing cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2000;14(3):339-43.
Grigore AM, Grocott HP, Newman MF. Anesthetic management of patients with a brain tumor for cardiac surgery. J Cardiothorac Vasc Anesth 2000;14(6):702-4.
Grigore AM, Mathew JP, Grocott HP, Reves JG, Blumenthal JA, White WD, Smith PK, Jones RH, Kirchner JL, Mark DB, Newman MF. Prospective randomized trial of normothermic versus hypothermic cardiopulmonary bypass on cognitive function after coronary artery bypass graft surgery. Anesthesiology 2001; 95: 1110-1119.
Grigore AM, Grocott HP, Mathew JP, Phillips-Bute B, Stanley T, Butler A, Landolfo KP, Reves JG, Blumenthal JA, Newman MF. The rewarming rate and increased peak temperature alter neurocognitive outcome after cardiac surgery. Anesth Analg 2002; 94(1): 4-10.
Grocott HP, Mackensen GB, Grigore AM, Mathew JP, Reves JG, Phillips-Bute B, Smith PK, Newman MF, and the Neurologic Outcome Research Group (NORG) and Cardiothoracic Anesthesiology Research Endeavors (CARE) Investigators of the Duke Heart Center. Postoperative hyperthermia is associated with cognitive dysfunction following coronary artery bypass graft surgery. Stroke 2002; 33: 537-41.
Tsusaki B, Grigore A, Cooley DA, Collard CD. Reversal of delayed paraplegia with cerebrospinal fluid drainage after thoracoabdominal aneurysm repair. Anesth Analg 2002; 94(6): 1674.
Amory DW, Grigore AM, Amory JK, Gerhardt MA, White WD, Smith PK, Schwinn DA, Reves JG, Newman MF. Neuroprotection is Associated with Beta Andrenergic Receptor Antagonists During Cardiac Surgery: Suggestive Evidence from 2,575 Patients. J Cardiothorac Vasc Anesth 2002; 16(3): 270-277.
Bick RJ, Poindexter B, Buja LM, Grigore A, Nussmeier N, Radovancevic B, and Frazier O.H. Alterations in Cardiomyocytes following Left Ventricular Unloading. Recent Res. Devel. Membrane Biol., 1(2002): 1-10.
Grigore A, Poindexter B, Vaughn WK, Nussmeier N, Frazier O.H., Cooper JR, Gregoric I, Buja LM, Bick R. Alterations in Alpha Adrenoreceptor Density and Localization After Mechanical Left Ventricular Unloading With the Jarvik Flowmaker Left Ventricular Assist Device. Journal of Heart and Lung Transplantation 2005; 24(5): 609-613.
Bick RJ, Bagwell SH, Jones CJ, Poindexter BJ, Buja ML, Youker KA, Grigore AM, Clubb F, Radovancevic B, Frazier OH. Fluorescence imaging microscopy of cellular markers in ischemic versus non-ischemic cardiomyopathy following left ventricular unloading. Journal of Heart and Lung Transplantation 2005; 24(4): 454-461.
Bick RJ, Grigore, AM, Poindexter BJ, Schnee PM, Nussmeier NA, Gregoric ID, Shah NA, Myers TJ, Buja LM, Frazier OH. Left ventricular unloading with an assist device results in receptor relocalization as well as increased beta-adrenergic receptor numbers: Are these changes indications for outcome? J Card Surg 2005; 20: 332-336.
Sethi M, Grigore AM, Davison JK. Proceeding with thoracoabdominal aortic aneurysm surgery after encountering a bloody tap during CSF catheter placement. J Cardiothorac Vasc Anesth 2006; 20: 269-272.
Bracey AW, Grigore AM, Nussmeier NA. Impact of platelet testing on presurgical screening: implications for cardiac and noncardiac surgical procedures. Am J Cardiol 2006;98[suppl]:25N-32N.
Levy JH, Macao MY, Gitter R, Kereiakes DJ, Grigore AM, Aronson S, Newman MF: Clevidipine effectively and rapidly controls blood pressure preoperatively in cardiac surgery patients: The result of the randomized, placebo-controlled efficacy study of clevidipine assessing its preoperative antihypertensive effect in cardiac surgery-1. Anesth Analg 2007;105:918-925.
Marzolino PS, Reynolds JH, Coselli JS, Grigore AM. Contained ascending aortic Rupture. Texas Heart Journal 2008; 35:555-558.
Grigore AM. Surgical Interventions for Heart Failure. Applied Cadiopulmonary Pathophysiology 2007;11:39-40.
Bennett-Guerrero E, Swaminathan M, Grigore AM, Roach GW, Aberle LG, Johnston JM, Fink MP. A phase II multicenter double-blind placebo-controlled study of ethyl pyruvate in high risk patients undergoing cardiac surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2009; 23:324-9.
Grigore AM, Murray Friederich C, Ramakrishna H, Djainai G. Temperature regimens and neuroprotection during cardiopulmonary bypass: does rewarming matter? Anesth Analg 2009;109:1741-51.
Thunberg CA, Gaitan BD, Arabia FA, Cole DJ, Grigore AM. Ventricular assist devices today and tomorrow. Journal of Cardiothoracic and Vascular Anesthesia (in press) 2009
Audio/Video/CD-ROM
Grigore AM, RR Joe, R Savage. Intraoperative Echocardiographic Assessment of Patients Undergoing Procedures for Congestive Heart Failure. Comprehensive Review of Perioperative Transesophageal Echocardiography. R. Savage, S. Aronson, J. Shanewise, WJ Stewart, J. Thomas. DVD, 2007 Lippincott Williams and Wilkins, Baltimore MD
Book Chapters
Grigore AM, Thys DM. "History and Physical Examination." Textbook of Cardiovascular Anesthesiology. McGraw-Hill Companies, pp 27-47, 2001.
Grocott HP, Grigore AM. "Cardiopulmonary Bypass in a Patient with a Brain Tumor." Problems in Anesthesia: Cardiothoracic Surgery. Arrowsmith JE, Simpson J (Eds). London: Martin Dunitz, pp 17-23, 2002.
Grigore AM, RR Joe, R Savage. "Intraoperative Echocardiographic Assessment of Patients Undergoing Procedures for Congestive Heart Failure." Comprehensive Review of Perioperative Transesophageal Echocardiography. R. Savage, S. Aronson, J. Shanewise, WJ Stewart, J. Thomas. Lippincott Williams and Wilkins, Baltimore MD pp 615-642, 2005.
Djainai G, Ramakrishna H, Grigore AM. "Temperature and Brain Protection." Monographs in Cardiac Surgery. Springer (in press)
Nussmeier NA, Hauser MC, Sarwar MF, Grigore AM, Searles, BE. "Anesthesia for Cardiac Surgery." Miller’s Anesthesia. 7th Edition. Volume 2. Philadelphia: Churchil Livingstone/Elsevier;2010, p 1889-975.
Grigore AM, Thunberg CA, Savage RM, Smedira NJ. "Surgical consideration and assessment in heart failure surgery." In: Savage RM, Aronson S, Shernan S: Comprehensive review of perioperative transesophageal echocardiography. 2nd Edition. Baltimore: Lippincott Williams and Wilkins (in press) 2010.
Grigore AM. "Transesophageal Echocardiography-intraoperative Use." In Faust’s Anesthesia Review 4th Edition (in press) 2010