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https://www.readbyqxmd.com/read/28098429/natural-history-of-nonimmune-mediated-thrombocytopenia-and-acute-kidney-injury-in-pediatric-open-heart-surgery
#1
Shannon Tew, Manuel L Fontes, Nathaniel H Greene, Miklos D Kertai, George Ofori-Amanfo, Robert D B Jaquiss, Andrew J Lodge, Warwick A Ames, Hercilia Mayumi Homi, Kelly A Machovec, Edmund H Jooste
OBJECTIVE: Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts and AKI has not been investigated in the pediatric population. Our objective was to investigate this relationship and examine independent predictors of AKI. DESIGN: After IRB approval, we performed a retrospective review of the institution's medical records and database...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28097800/inception-and-utility-of-a-renal-replacement-registry-using-administrative-health-data-in-north-east-italy
#2
Francesca Valent, Anna Busolin, Giuliano Boscutti
BACKGROUND: Disease registries are useful tools for public health planning, evaluating clinical practice and providing information on cohorts of patients. METHODS: The administrative databases of the regional health information system of Friuli Venezia Giulia, Italy were used to build a regional registry of the resident population in renal replacement therapy (including dialysis and renal transplantation), through an algorithm taking into account hospital discharge and outpatient ambulatory care data...
January 18, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28097735/autoimmune-enteropathy-and-hepatitis-in-pediatric-heart-transplant-recipient
#3
Kimberly Lewis, Ryan Butts, J Antonio Quiros, Michelle Hudspeth, Katherine Twombley, Andrew Savage, Sally Self, Ali Burnette, Shaoli Sun
AIE is a rare disorder in children that presents with severe diarrhea and malabsorption, caused by immune-mediated damage to intestinal mucosa. AIE is often associated with various syndromes of immunodeficiency including IPEX syndrome (immune dysregulation, polyendocrinopathy and enteropathy, X-linked). Dysfunctional T regulatory cells are the source of pathology in both IPEX syndrome and AIE as they are essential in maintaining tolerance to self-antigens and eliminating autoreactive B cells. This case report describes a 10-year-old cardiac transplant and total thymectomy patient on chronic immunosuppression with tacrolimus that presented with AIE and extraintestinal manifestations of cyclical hepatitis...
January 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28095640/irradiation-before-and-donor-splenocyte-infusion-immediately-after-transplantation-induce-tolerance-to-lung-but-not-heart-allografts-in-miniature-swine
#4
Wiebke Sommer, Gwen Buechler, Katharina Jansson, Murat Avsar, Ann-Kathrin Knöfel, Jawad Salman, Klaus Hoeffler, Thierry Siemeni, Jens Gottlieb, Johann H Karstens, Danny Jonigk, Ansgar Reising, Axel Haverich, Martin Strüber, Gregor Warnecke
Solid organs may differ in their potential to induce and maintain a state of donor-specific tolerance. Previously, we induced stable immunological tolerance in a lung transplantation model in miniature swine. Here, we wished to transfer this established protocol into a heart transplantation model in miniature swine. Heterotopic heart transplantation (HTX) was performed in four, and left-sided lung transplantation (LTX) in seven minipigs from gender and SLA mismatched donors. All recipients received non-myeloablative irradiation, donor splenocyte infusion and intravenous pharmacologic immunosuppression for 28 postoperative days...
January 17, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28095452/influence-of-mechanical-circulatory-support-on-endothelin-receptor-expression-in-human-left-ventricular-myocardium-from-patients-with-dilated-cardiomyopathy-dcm
#5
Florian Gärtner, Getu Abraham, Astrid Kassner, Daniela Baurichter, Hendrik Milting
BACKGROUND: In terminal failing hearts ventricular assist devices (VAD) are implanted as a bridge to transplantation. Endothelin receptor (ETR) antagonists are used for treatment of secondary pulmonary hypertension in VAD patients. However, the cardiac ETR regulation in human heart failure and during VAD support is incompletely understood. METHODS: In paired left ventricular samples of 12 dilated cardiomyopathy patients we investigated the density of endothelin A (ETA) and B (ETB) receptors before VAD implantation and after device removal...
2017: PloS One
https://www.readbyqxmd.com/read/28094175/septic-shock-in-low-cardiac-output-patients-with-heart-and-lung-transplantation-diagnosis-and-management-dilemma
#6
Ajay Kumar Jha, Shrinivas Krisna Hittalmani
No abstract text is available yet for this article.
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28093805/heartware-ventricular-assist-device-implantation-in-patients-with-fontan-physiology
#7
Bartlomiej R Imielski, Robert A Niebler, Steven J Kindel, Ronald K Woods
We aim to describe the clinical course of a series of patients with hypoplastic left heart syndrome and refractory systolic heart failure supported with a HeartWare ventricular assist device (HVAD) following Fontan palliation. This is a retrospective review of three consecutive patients supported with a HVAD following Fontan palliation through February 2016. Data include patient characteristics, operative variables, postimplantation hemodynamic/device parameters, event outcomes, and duration of HVAD support...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28093804/successful-bridge-to-transplant-of-functionally-univentricular-patients-with-a-modified-continuous-flow-ventricular-assist-device
#8
Michael C Mongé, Bradley T Kulat, Osama Eltayeb, Neale R Zingle, Steven T Moss, Jeffrey G Gossett, Elfriede Pahl, John M Costello, Carl L Backer
A continuous flow extracorporeal ventricular assist device (VAD) was modified to support functionally univentricular infants and children awaiting heart transplantation. A centrifugal VAD, designed to flow from 1.5 to 8 L/min, was used as a bridge-to-transplant in four patients with functionally univentricular circulation. A variable restrictive recirculation shunt permitted lower flow ranges in small patients. In hypoxic patients, an oxygenator was incorporated into the circuit. From 2012 to 2015, the modified VAD was placed in four patients with Glenn physiology...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28092289/the-impact-of-obesity-on-heart-failure
#9
Alexander B Zhai, Haissam Haddad
PURPOSE OF REVIEW: Obesity, a growing global health problem, contributes to the development of heart failure. However, increased BMI seems protective for those with established disease, a phenomenon known as the 'obesity paradox'. In this review, we outline the mechanism through which obesity can contribute to the development of heart failure, explore the concept of obesity paradox, and highlight the challenges that obesity presents for advanced heart failure therapy. RECENT FINDINGS: Although the mechanism underlying the obesity paradox is complex, meta-analysis shows that intentional weight loss through bariatric surgery can indeed improve cardiac structure and function...
January 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28092203/machine-learning-of-three-dimensional-right-ventricular-motion-enables-outcome-prediction-in-pulmonary-hypertension-a-cardiac-mr-imaging-study
#10
Timothy J W Dawes, Antonio de Marvao, Wenzhe Shi, Tristan Fletcher, Geoffrey M J Watson, John Wharton, Christopher J Rhodes, Luke S G E Howard, J Simon R Gibbs, Daniel Rueckert, Stuart A Cook, Martin R Wilkins, Declan P O'Regan
Purpose To determine if patient survival and mechanisms of right ventricular failure in pulmonary hypertension could be predicted by using supervised machine learning of three-dimensional patterns of systolic cardiac motion. Materials and Methods The study was approved by a research ethics committee, and participants gave written informed consent. Two hundred fifty-six patients (143 women; mean age ± standard deviation, 63 years ± 17) with newly diagnosed pulmonary hypertension underwent cardiac magnetic resonance (MR) imaging, right-sided heart catheterization, and 6-minute walk testing with a median follow-up of 4...
January 16, 2017: Radiology
https://www.readbyqxmd.com/read/28090305/resolution-of-myelofibrosis-associated-pulmonary-arterial-hypertension-following-allogeneic-hematopoietic-stem-cell-transplantation
#11
Saadia A Faiz, Cezar Iliescu, Juan Lopez-Mattei, Bela Patel, Lara Bashoura, Uday Popat
We present the case of a 62-year-old man with myelofibrosis-associated pulmonary arterial hypertension (PAH) who underwent allogeneic hematopoietic stem cell transplantation with subsequent resolution of disease and PAH. Right heart catheterization was used to guide PAH therapy before and after transplantation. Drug interactions, adverse effects, and renal insufficiency posed clinical challenges for the management of PAH-specific medications after transplantation. PAH improved soon after transplantation, and vasoactive medications were tapered off...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28089194/left-ventricular-global-longitudinal-strain-predicts-major-adverse-cardiac-events-and-all-cause-mortality-in-heart-transplant-patients
#12
Tor Skibsted Clemmensen, Hans Eiskjær, Brian Bridal Løgstrup, Lars Bo Ilkjær, Steen Hvitfeldt Poulsen
BACKGROUND: Left ventricular global longitudinal strain (LVGLS) is a robust longitudinal myocardial deformation marker that is strongly affected by cardiac allograft vasculopathy (CAV), microvascular dysfunction, and acute cellular rejection (ACR). We evaluated graft deformation for risk stratification in long-term heart transplant (HTx) patients. METHODS: The study included 196 patients who underwent HTx between 2011 and 2013. Patients underwent comprehensive echocardiography and coronary angiography...
December 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28089072/the-role-of-implantable-cardioverter-defibrillators-in-patients-bridged-to-transplantation-with-a-continuous-flow-left-ventricular-assist-device-a-propensity-score-matched-analysis
#13
Kevin J Clerkin, Veli K Topkara, Donna M Mancini, Melana Yuzefpolskaya, Ryan T Demmer, Jose M Dizon, Koji Takeda, Hiroo Takayama, Yoshifumi Naka, Paolo C Colombo, A Reshad Garan
BACKGROUND: Implantable cardioverter defibrillators (ICDs) provide a significant mortality benefit for appropriately selected patients with advanced heart failure. ICDs are associated with a mortality benefit when used in patients with a pulsatile left ventricular assist device (LVAD). It is unclear whether patients with a continuous-flow LVAD (CF-LVAD) derive the same benefit. We sought to determine if the presence of an ICD provided a mortality benefit during CF-LVAD support as a bridge to transplantation...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#14
Bill C Tran, Prabhjot S Nijjar
BACKGROUND: There is an urgent need for further studies evaluating the role of imaging modalities in the management of left ventricular assist device (LVAD) thrombosis. This study reviews the role of computed tomography (CT) in the diagnosis of suspected LVAD thrombosis. METHODS: All contrast chest CTs performed in patients with suspected LVAD thrombosis at the University of Minnesota between January 2008 and April 2014 were reviewed. Significant CT findings were identified, operative notes were reviewed, and patient outcomes were reported...
January 15, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28087606/reinnervation-post-heart-transplantation
#15
Avishay Grupper, Henry Gewirtz, Sudhir Kushwaha
Heart transplantation results in complete denervation of the donor heart with loss of afferent and efferent nerve connections. The majority of patients remain completely denervated during the first 6-12 months following transplantation. Evidence of reinnervation is usually found during the second year after transplantation and involve the myocardial muscle, sinoatrial node, and coronary vessels, but remains incomplete and regionally limited many years post-transplant. Restoration of cardiac innervation can improve exercise capacity as well as blood flow regulation in the coronary arteries, and hence improve quality of life...
January 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28087483/cell-number-per-spheroid-and-electrical-conductivity-of-nanowires-influence-the-function-of-silicon-nanowired-human-cardiac-spheroids
#16
Yu Tan, Dylan Richards, Robert C Coyle, Jenny Yao, Ruoyu Xu, Wenyu Gou, Hongjun Wang, Donald R Menick, Bozhi Tian, Ying Mei
: Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) provide an unlimited cell source to treat cardiovascular diseases, the leading cause of death worldwide. However, current hiPSC-CMs retain an immature phenotype that leads to difficulties for integration with adult myocardium after transplantation. To address this, we recently utilized electrically conductive silicon nanowires (e-SiNWs) to facilitate self-assembly of hiPSC-CMs to form nanowired hiPSC cardiac spheroids...
January 10, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28087362/clinical-phenotypes-and-outcomes-of-heritable-and-sporadic-pulmonary-veno-occlusive-disease-a-population-based-study
#17
David Montani, Barbara Girerd, Xavier Jaïs, Marilyne Levy, David Amar, Laurent Savale, Peter Dorfmüller, Andrei Seferian, Edmund M Lau, Mélanie Eyries, Jérôme Le Pavec, Florence Parent, Damien Bonnet, Florent Soubrier, Elie Fadel, Olivier Sitbon, Gérald Simonneau, Marc Humbert
BACKGROUND: Bi-allelic mutations of the EIF2AK4 gene cause heritable pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis (PVOD/PCH). We aimed to assess the effect of EIF2AK4 mutations on the clinical phenotypes and outcomes of PVOD/PCH. METHODS: We did a population-based study using clinical, functional, and haemodynamic data from the registry of the French Pulmonary Hypertension Network. We reviewed the clinical data and outcomes from all patients referred to the French Referral Centre (Pulmonary Department, Hospital Kremlin-Bicêtre, University Paris-Sud) with either confirmed or highly probable PVOD/PCH with DNA available for mutation screening (excluding patients with other risk factors of pulmonary hypertension, such as chronic respiratory diseases)...
January 10, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28087175/continuous-improvement-in-outcome-after-heart-transplantation-long-term-follow-up-after-three-decades-of-experience
#18
Göran Dellgren, Andreas Westerlind, Hans Liden, Jakob Gäbel, Sven-Erik Bartfay, Entela Bollano, Erik Holmberg, Bert Andersson, Henrik Schersten, Kristjan Karason
AIMS: Heart transplantation (HTx) has become the standard treatment for patients with end-stage heart disease. We report on the long-term outcome after HTx at our centre and investigate trends in outcome over time. METHODS: During the period, between 1984 and 2014, a total of 610 HTx procedures were performed in 595 patients (median 48years; IQR 31-57years; range 24days-71years; mean 43years; 75% male) in our institution. Long-term outcome was investigated in the whole cohort, among children (n=76), bridged with mechanical circulatory support (MCS, n=131), re-transplanted (n=17), and concomitant kidney transplantation (n=12)...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28087104/improved-outcomes-from-extracorporeal-membrane-oxygenation-versus-ventricular-assist-device-temporary-support-of-primary-graft-dysfunction-in-heart-transplant
#19
Koji Takeda, Boyangzi Li, Arthur R Garan, Veli K Topkara, Jiho Han, Paolo C Colombo, Maryjane A Farr, Yoshifumi Naka, Hiroo Takayama
BACKGROUND: Primary graft dysfunction (PGD) is one of the most common causes of early death after orthotopic heart transplantation. Mechanical circulatory support devices are required for severe forms of PGD. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) and temporary ventricular assist device (VAD) support have both been reported to be useful for severe PGD. METHODS: Between January 2007 and December 2015, 597 patients received a heart transplant at our center...
December 23, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28081298/full-thickness-heart-repair-with-an-engineered-multilayered-myocardial-patch-in-rat-model
#20
Seokwon Pok, Igor V Stupin, Christopher Tsao, Robia G Pautler, Yang Gao, Raymond M Nieto, Ze-Wei Tao, Charles D Fraser, Ananth V Annapragada, Jeffrey G Jacot
In a rat model of right free wall replacement, the transplantation of an engineered multilayered myocardial patch fabricated from a polycaprolactone membrane supporting a chitosan/heart matrix hydrogel induces significant muscular and vascular remodeling and results in a significantly higher right ventricular ejection fraction compared to use of a commercially available pericardium patch.
January 12, 2017: Advanced Healthcare Materials
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