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https://www.readbyqxmd.com/read/29056460/use-of-a-percutaneous-temporary-circulatory-support-device-as-a-bridge-to-decision-during-acute-decompensation-of-advanced-heart-failure
#1
Shelley A Hall, Nir Uriel, Sandra A Carey, Michelle Edens, Geoffrey Gong, Michele Esposito, Ryan O'Kelly, Shiva Annamalai, Nima Aghili, S Adatya, Navin K Kapur
BACKGROUND: Prognosis is poor for patients with decompensated advanced heart failure (HF) refractory to medical therapy. Evaluating candidacy for durable mechanical circulatory support (MCS), cardiac transplantation, or palliative care is complex, and time is often needed to stabilize the patient hemodynamically. The Impella 5.0 (Abiomed, Danvers, MA) is a minimally invasive axial-flow catheter capable of providing full temporary hemodynamic support. We report a multicenter series on the use of this device for bridge to decision (BTD) in decompensated advanced HF patients...
September 30, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29056228/comparison-of-clinical-characteristics-complications-and-outcomes-in-recipients-having-heart-transplants-65-years-of-age-versus-%C3%A2-65-years-of-age
#2
Aayla Jamil, Huanying Qin, Joost Felius, Giovanna Saracino, Aldo E Rafael, Juan C MacHannaford, Gonzalo V Gonzalez-Stawinski, Brian Lima
Advanced recipient age remains a limiting factor for heart transplant candidacy, with many centers reluctant to transplant older patients. Here, we report our experience with recipients aged ≥65 years compared with younger recipients in terms of baseline characteristics, intraoperative and immediate postoperative experiences, and post-transplant morbidity and survival. The main study outcome was primary graft dysfunction (PGD), which has not been widely studied in this population. Donor and recipient data from 255 heart transplantations performed between 2012 and 2016 were reviewed...
September 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29055604/treatment-of-primary-graft-dysfunction-after-lung-transplantation-with-orally-inhaled-ap301-a-prospective-randomized-pilot-study
#3
Clemens Aigner, Alexis Slama, Maximilian Barta, Andreas Mitterbauer, Gyoergy Lang, Shahrokh Taghavi, Jose Matilla, Roman Ullrich, Katharina Krenn, Peter Jaksch, Klaus Markstaller, Walter Klepetko
BACKGROUND: Primary graft dysfunction (PGD) after lung transplantation (LTx) carries significant morbidity and mortality in the early post-operative period and is associated with the development of chronic lung allograft dysfunction. AP301, an activator of epithelial sodium channel-mediated Na(+) uptake represents a new concept for prevention and treatment of pulmonary edema and has shown promising results in the pre-clinical setting. This pilot study investigated the clinical effect of inhaled AP301 on patients with development of PGD > 1 according to International Society of Heart and Lung Transplantation criteria after primary LTx in a high-volume center and was conducted as a randomized, placebo-controlled, single-center pilot-study including 20 patients...
September 30, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29055603/end-stage-renal-disease-after-pediatric-heart-transplantation-a-25-year-national-cohort-study
#4
Swati Choudhry, Vikas R Dharnidharka, Chesney D Castleberry, Charles W Goss, Kathleen E Simpson, Kenneth B Schechtman, Charles E Canter
BACKGROUND: End-stage renal disease (ESRD), defined as the need for chronic dialysis and/or kidney transplantation (KTx), is a known complication after heart transplant (HTx). However, factors associated with ESRD are not well elucidated. The objectives of this study were to determine the prevalence, risk factors, and outcomes associated with ESRD after pediatric HTx. METHODS: Scientific Registry of Transplant Recipients data were linked, using direct identifiers, to the United States Renal Data System to identify patients (aged ≤ 18 years) who underwent primary HTx between 1989 and 2013...
October 2, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29055602/late-graft-dysfunction-after-pediatric-heart-transplantation-is-associated-with-fibrosis-and-microvasculopathy-by-automated-digital-whole-slide-analysis
#5
Brian Feingold, Jennifer Picarsic, Andrew Lesniak, Benjamin A Popp, Michelle A Wood-Trageser, Anthony J Demetris
BACKGROUND: Histopathologic features of late graft dysfunction (LGD) in endomyocardial biopsies (EMBs) after pediatric heart transplantation (HT) have been incompletely described and rarely quantified. We employed automated, morphometric analysis of whole-slide EMB images to objectively quantify fibrosis and microvasculopathy after pediatric HT. METHODS: Nine recipients with clinical LGD were matched with controls on age, listing diagnosis, crossmatch and time since HT...
September 29, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29055147/cognitive-function-among-long-term-survivors-of-heart-transplantation
#6
Britta S Bürker, Einar Gude, Lars Gullestad, Ingelin Grov, Anne Relbo Authen, Arne K Andreassen, Odd E Havik, Mary Amanda Dew, Arnt E Fiane, Ira R Haraldsen, Ulrik F Malt, Stein Andersson
BACKGROUND: Cognitive impairment is documented early after heart transplantation (HTx), but we lack data on cognitive function beyond the fourth year posttransplant. Against the background of good long-term survival, this knowledge is necessary to improve clinical care throughout the entire posttransplant period. METHODS: We assessed cognitive function with a neuropsychological test battery in a sample of HTx recipients ≥16 years posttransplant. To improve clinical utility, we also applied adapted consensus criteria for Mild Cognitive Impairment (MCI)...
October 21, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29054843/contribution-of-extra-cardiac-cells-in-murine-heart-valves-is-age-dependent
#7
Lindsey J Anstine, Tori E Horne, Edwin M Horwitz, Joy Lincoln
BACKGROUND: Heart valves are dynamic structures that open and close over 100 000 times a day to maintain unidirectional blood flow during the cardiac cycle. Function is largely achieved by highly organized layers of extracellular matrix that provide the necessary biomechanical properties. Homeostasis of valve extracellular matrix is mediated by valve endothelial and interstitial cell populations, and although the embryonic origins of these cells are known, it is not clear how they are maintained after birth...
October 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29054235/acquired-cor-triatriatum-sinister-after-the-fontan-operation-and-successful-resection-in-a-child
#8
S Javed Zaidi, Rishi R Adhikari, Chawki El-Zein, Saad Siddiqui
Cor triatriatum sinister is a rare congenital lesion encountered in children. It consists of a fibromuscular membrane that separates the left atrium into two chambers resulting in a triatrial heart and often occurs with other structural cardiac anomalies. The acquired form is uncommon and has only been reported after orthotopic heart transplantation or as a complication of infective endocarditis in adults. These cases were mostly because of hypertrophied atrial tissue or suture lines and torsion of the atrium...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29054138/mdivi-1-protects-human-w8b2-cardiac-stem-cells-from-oxidative-stress-and-simulated-ischemia-reperfusion-injury
#9
Ayeshah A Rosdah, Simon T Bond, Priyadharshini Sivakumaran, Ashfaqul Hoque, Jonathan S Oakhill, Brian G Drew, Lea Md Delbridge, Shiang Yong Lim
Cardiac stem cell (CSC) therapy is a promising approach to treat ischemic heart disease. However, the poor survival of transplanted stem cells in the ischemic myocardium has been a major impediment in achieving an effective cell-based therapy against myocardial infarction. Inhibiting mitochondrial fission has been shown to promote survival of several cell types. However, the role of mitochondrial morphology in survival of human CSC remains unknown. In this study, we investigated whether Mdivi-1, an inhibitor of mitochondrial fission protein Drp1, can improve survival of a novel population of human W8B2+ CSCs in hydrogen peroxide-induced oxidative stress and simulated ischemia-reperfusion injury models...
October 20, 2017: Stem Cells and Development
https://www.readbyqxmd.com/read/29053805/longitudinal-measures-of-deformation-are-associated-with-a-composite-measure-of-contractility-derived-from-pressure-volume-loop-analysis-in-children
#10
Shahryar M Chowdhury, Ryan J Butts, Carolyn L Taylor, Varsha M Bandisode, Karen S Chessa, Anthony M Hlavacek, Arni Nutting, Girish S Shirali, G Hamilton Baker
Aims: The relationship between echocardiographic measures of left ventricular (LV) systolic function and reference-standard measures have not been assessed in children. The objective of this study was to assess the validity of echocardiographic indices of LV systolic function via direct comparison to a novel composite measure of contractility derived from pressure-volume loop (PVL) analysis. Methods and results: Children with normal loading conditions undergoing routine left heart catheterization were prospectively enrolled...
June 29, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29050751/fibrosis-related-gene-expression-in-single-ventricle-heart-disease
#11
Stephanie J Nakano, Austine K Siomos, Anastacia M Garcia, Hieu Nguyen, Megan SooHoo, Csaba Galambos, Karin Nunley, Brian L Stauffer, Carmen C Sucharov, Shelley D Miyamoto
OBJECTIVE: To evaluate fibrosis and fibrosis-related gene expression in the myocardium of pediatric subjects with single ventricle with right ventricular failure. STUDY DESIGN: Real-time quantitative polymerase chain reaction was performed on explanted right ventricular myocardium of pediatric subjects with single ventricle disease and controls with nonfailing heart disease. Subjects were divided into 3 groups: single ventricle failing (right ventricular failure before or after stage I palliation), single ventricle nonfailing (infants listed for primary transplantation with normal right ventricular function), and stage III (Fontan or right ventricular failure after stage III)...
October 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29050500/prophylactic-fibrinogen-decreases-postoperative-bleeding-but-not-acute-kidney-injury-in-patients-undergoing-heart-transplantation
#12
Alireza Jahangirifard, Zargham Hossein Ahmadi, Farah Naghashzadeh, Babak Sharif-Kashani, Farin Rashidfarrokhi, Ali Afshar, Reyhaneh Yamini-Sharif, Yousef Rezaie
The present study is the premier clinical attempt to scrutinize the practicability of prophylactic fibrinogen infusion in patients undergoing heart transplantation (HT). A total of 67 consecutive patients who had undergone HT between January 2012 and December 2014 were assessed. After exclusion of some patients, 23 patients were given preoperative 2 g fibrinogen concentrate over a period of 15 minutes after the termination of cardiopulmonary bypass pump and complete reversal of heparin, and 30 patients were not given...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29050128/-lung-transplantation-for-connective-tissue-disease-associated-interstitial-lung-disease-recipient
#13
J Zhang, B Wu, M Zhou, D Liu, L Fan, D Wei, H Yang, J Y Chen
Objective: To investigate the timing and complications of lung transplantation for the treatment of connective tissue disease-associated interstitial lung disease (CTD-ILD). Method: The clinical data of connective tissue-associated disease lung transplantation recipients from September, 2015 to February, 2017 were collected. Results: 11 patients with CTD-ILD were evaluated by lung transplantation and were treated with lung transplantation. Including 2 cases dermatomyositis/polymyositis and interstitial lung disease (PM/DM-ILD), 4 cases rheumatoid arthritis and interstitial lung disease (RA-ILD), 4 cases of primary Sjgren's syndrome and interstitial lung disease (pSS-ILD), 1 case of systemic sclerosis and interstitial lung disease (SSc-ILD)...
October 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29049683/ventricular-assist-device-in-a-failing-total-cavopulmonary-connection-a-new-step-by-step-approach
#14
Carlo Pace Napoleone, Maria Teresa Cascarano, Luca Deorsola, Andrea Valori
The management of failing Fontan patients with mechanical circulatory support has been reported with unsatisfactory results. A 5-year-old girl, listed for heart transplantation for failing Fontan, underwent rescue extracorporeal membrane oxygenation support. As it was necessary to move the patient to the Berlin Heart Excor, a step-by-step approach was designed to obtain a gradual adaptation to this form of support. A central extracorporeal membrane oxygenation, with a Berlin Heart apical and aortic cannulae, was implanted leaving the previously positioned femoral vein cannula in parallel with the outflow apical one...
September 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049612/long-term-change-in-the-risk-of-skin-cancer-after-organ-transplantation-a-population-based-nationwide-cohort-study
#15
Syed Mohammad Husain Rizvi, Bjarte Aagnes, Hallvard Holdaas, Einar Gude, Kristin Muri Boberg, Øystein Bjørtuft, Per Helsing, Torbjørn Leivestad, Bjørn Møller, Petter Gjersvik
Importance: The high risk of skin cancer after organ transplantation is a major clinical challenge and well documented, but reports on temporal trends in the risk of posttransplant cutaneous squamous cell carcinoma (SCC) are few and appear contradictory. Objective: To study temporal trends for the risk of skin cancer, particularly SCC, after organ transplantation. Design, Setting, and Participants: Population-based, nationwide, prospective cohort study of 8026 patients receiving a kidney, heart, lung, or liver transplant in Norway from 1968 through 2012 using patient data linked to a national cancer registry...
October 18, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/29049046/determination-of-death-in-donation-after-circulatory-death-an-ethical-propriety
#16
Andrew McGee, Dale Gardiner, Paul Murphy
PURPOSE OF REVIEW: The recently developed donation after circulatory death (DCD) heart transplant technique, pioneered by Papworth Hospital in the UK, involves the use of extracorporeal perfusion technologies to restart the donor heart in situ and thereby restore the donor's own circulation, after first isolating the donor's cerebral circulation. By restoring the circulation in the deceased donor, even if the cerebral circulation is excluded, the Papworth technique challenges the acceptability of death determination in DCD...
October 18, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29047321/perioperative-and-anesthetic-considerations-in-pulmonary-atresia-with-intact-ventricular-septum
#17
Stephen Gleich, Gregory J Latham, Denise Joffe, Faith J Ross
Pulmonary atresia with intact ventricular septum (PA/IVS) is a rare right-heart obstructive lesion with a wide anatomic and physiologic spectrum of disease, ranging from simple membranous pulmonary valve atresia with a fully developed right ventricle (RV) to a severely hypoplastic RV and ventriculocoronary (RV-coronary) fistulas. Affected neonates are dependent on prostaglandin for adequate pulmonary blood flow. Depending on the severity of disease, treatment options range from transcatheter pulmonary valve perforation and ultimate biventricular repair to staged single-ventricle palliation...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29046779/anesthetic-management-during-the-first-combined-heart-liver-transplant-performed-in-korea-a-case-report
#18
Hyejin Park, Jungchan Park, Jonghwan Lee, Gaabsoo Kim
Herein, we describe the anesthetic management during the first combined heart-liver transplant (CHLT) performed in Korea. Though CHLT is a rare procedure, accumulating evidence suggests that it is a feasible option for patients with coexisting heart and liver failure. A 45-year-old female patient presented with severe cardiac dysfunction requiring extracorporeal membrane oxygenation (ECMO) support and secondary congestive hepatopathy. The patient underwent consecutive heart and liver transplantation using extracorporeal circulatory devices-heart transplant with cardiopulmonary bypass, and liver transplant with peripheral ECMO...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046675/interpreting-t-cell-cross-reactivity-through-structure-implications-for-tcr-based-cancer-immunotherapy
#19
Dinler A Antunes, Maurício M Rigo, Martiela V Freitas, Marcus F A Mendes, Marialva Sinigaglia, Gregory Lizée, Lydia E Kavraki, Liisa K Selin, Markus Cornberg, Gustavo F Vieira
Immunotherapy has become one of the most promising avenues for cancer treatment, making use of the patient's own immune system to eliminate cancer cells. Clinical trials with T-cell-based immunotherapies have shown dramatic tumor regressions, being effective in multiple cancer types and for many different patients. Unfortunately, this progress was tempered by reports of serious (even fatal) side effects. Such therapies rely on the use of cytotoxic T-cell lymphocytes, an essential part of the adaptive immune system...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29045467/the-dose-of-hydroxyethyl-starch-6-130-0-4-for-fluid-therapy-and-the-incidence-of-acute-kidney-injury-after-cardiac-surgery-a-retrospective-matched-study
#20
Mona Momeni, Lompoli Nkoy Ena, Michel Van Dyck, Amine Matta, David Kahn, Dominique Thiry, André Grégoire, Christine Watremez
The safety of hydroxyethyl starches (HES) is still under debate. No studies have compared different dosing regimens of HES in cardiac surgery. We analyzed whether the incidence of Acute Kidney Injury (AKI) differed taking into account a weight-adjusted cumulative dose of HES 6% 130/0.4 for perioperative fluid therapy. This retrospective cohort study included all adult patients undergoing elective or emergency cardiac surgery with or without cardiopulmonary bypass. Exclusion criteria were patients on renal replacement therapy (RRT), cardiac trauma surgery, heart transplantation, patients with ventricular assist devices, subjects who required a surgical revision for bleeding and those whose medical records were incomplete...
2017: PloS One
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