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Orthotopic Heart Transplant

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https://www.readbyqxmd.com/read/29783995/bowel-obstruction-due-to-retained-intraperitoneal-left-ventricular-assist-device-lvad-driveline
#1
Daniel Miklin, Ivy Lewis, Howard Lieberman
BACKGROUND: Left ventricular assist devices (LVAD) provide a lifesaving bridge to cardiac transplant. Utilization of these devices is increasing in the United States. When a patient undergoes cardiac transplant, the left ventricular device is surgically removed and the driveline is extracted or left tunneled in the subcutaneous tissue. Our group encountered a rare and previously unreported complication of this device: intraperitoneal infiltration of a retained driveline after cardiac transplant causing a small bowel obstruction...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29775554/outcomes-and-predictors-of-early-infection-after-heart-transplantation
#2
Kendall C Shultes, Jerrica E Shuster, Scott Micek, Justin M Vader, Keki Balsara, Akinobu Itoh, Bethany R Tellor
BACKGROUND: Limited data exist on the incidence and outcome of early infection after orthotopic heart transplantation (OHT). The purpose of this study was to describe characteristics and outcomes of OHT recipients with an early infection and to identify predictors of such infections. METHODS: This retrospective, single-center study included patients greater than 18 years of age who underwent OHT from February 2009 to May 2014 and had an infection within 30 days of transplantation...
May 18, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29754672/trends-and-outcomes-of-cardiac-transplantation-from-donors-dying-of-drug-intoxication
#3
Haider J Warraich, Di Lu, Stacy Cobb, Lauren B Cooper, Adam DeVore, Chetan B Patel, Paul B Rosenberg, Jacob N Schroder, Mani A Daneshmand, Carmelo A Milano, Adrian F Hernandez, Joseph G Rogers, Robert J Mentz
BACKGROUND: Deaths from drug intoxication have increased in the United States but outcomes of recipients of orthotopic heart transplantation (OHT) from these donors are not well characterized. METHODS: We performed a retrospective analysis of the United Network for Organ Sharing's STAR database between January 2000 and March 2014 and assessed mortality and retransplantation using adjusted Cox models by mechanism of donor death. RESULTS: Of the 31,660 OHTs from 2000 to 2014, 1233 (3...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29728952/myocardial-perfusion-reserve-and-global-longitudinal-strain-as-potential-markers-of-coronary-allograft-vasculopathy-in-late-stage-orthotopic-heart-transplantation
#4
Akhil Narang, John E Blair, Mita B Patel, Victor Mor-Avi, Savitri E Fedson, Nir Uriel, Roberto M Lang, Amit R Patel
Coronary allograft vasculopathy (CAV) is a major cause of mortality in late-stage orthotopic heart transplantation (OHT) patients. Recent evidence has shown that myocardial perfusion reserve (MPR) derived from vasodilator cardiovascular magnetic resonance imaging (vCMR) and global longitudinal strain (GLS) from transthoracic echocardiography (TTE) are useful to detect CAV. However, previous studies have not comprehensively addressed whether these parameters are confounded by allograft rejection, myocardial scar/fibrosis, or allograft dysfunction...
May 4, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29724365/trends-and-cost-of-heart-transplantation-and-left-ventricular-assist-devices-impact-of-proposed-federal-cuts
#5
Nirav Patel, Rajat Kalra, Rajkumar Doshi, Navkaranbir S Bajaj, Garima Arora, Pankaj Arora
OBJECTIVES: The purpose of this study was to compare trends of use, in-hospital mortality, and annual expenditures associated with orthotopic heart transplantation (OHT) and left ventricular assist device (LVAD) implantation. In view of the changing health care landscape, we assessed the impact of federal funding cuts on Medicare and Medicaid beneficiaries seeking these procedures. BACKGROUND: Use and cost trends associated with OHT and LVAD are not well defined...
May 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29720347/a-review-of-the-use-of-direct-oral-anticoagulant-use-in-orthotopic-heart-transplantation-recipients
#6
REVIEW
Rosaleen Boswell, Glen J Pearson
No abstract text is available yet for this article.
April 16, 2018: Transplantation Reviews
https://www.readbyqxmd.com/read/29718266/donor-aortic-dissection-in-a-heart-transplantation-recipient
#7
Matteo Pozzi, Selina Hanna, Laurent Sebbag, Jean Francois Obadia
Aortic dissection after orthotopic heart transplantation is a rare condition, and a limited number of reports have been published in the literature. Herein, we report a case of Type A aortic dissection 16 years after heart transplantation.
April 26, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29706203/complications-of-radiofrequency-ablation-for-supraventricular-tachycardia-in-the-wolff-parkinson-white-syndrome-associated-with-noncompaction-cardiomyopathy
#8
William C Roberts, Paul A Grayburn, Shelley A Hall
Described herein is a 52-year-old man with Wolff-Parkinson-White syndrome and noncompaction cardiomyopathy who underwent 4 sternotomies to correct complications of 3 ablation procedures (2 open) for recurring supraventricular tachycardia, mitral valve repair for a damaged mitral valve during the third radiofrequency ablation procedure, and finally orthotopic heart transplantation.
March 23, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29681957/mechanical-circulatory-support-is-effective-to-treat-pulmonary-hypertension-in-heart-transplant-candidates-disqualified-due-to-unacceptable-pulmonary-vascular-resistance
#9
Michał Zakliczyński, Jerzy Pacholewicz, Izabela Copik, Marcin Maruszewski, Tomasz Hrapkowicz, Roman Przybylski, Marian Zembala
Introduction: High pulmonary vascular resistance (PVR) in orthotopic heart transplantation (OHT) candidates is a risk factor of right ventricle failure after the procedure. However, the increase of PVR may be a consequence of the life-threatening deterioration of the left ventricle function. The use of mechanical circulatory support (MCS) seems to be the best solution, but it is reimbursed only in active OHT candidates. Aim: We performed a retrospective analysis of MCS effectiveness in maintaining PVR at values accepted for OHT...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29663123/creation-of-a-restrictive-atrial-communication-in-heart-failure-with-preserved-and-mid-range-ejection-fraction-effective-palliation-of-left-atrial-hypertension-and-pulmonary-congestion
#10
Anna Bauer, Markus Khalil, Monika Lüdemann, Jürgen Bauer, Anoosh Esmaeili, Roberta De-Rosa, Norbert F Voelkel, Hakan Akintuerk, Dietmar Schranz
BACKGROUND: Left atrial decompression is considered in patients with symptomatic heart failure with preserved ejection fraction (HFpEF). We aimed to evaluate the feasibility and efficacy of transcatheter generation of a restrictive atrial septum communication to manage HFpEF from infancy to adulthood with cardiomyopathy and congenital heart defect. METHODS AND RESULTS: From June 2009 to December 2016, 24 patients (50% with an age less than 16 years) with HFpEF were palliated; NYHA-/Ross class IV (n = 10); median systemic ventricular ejection fraction 64 (range 35-78) %...
April 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29660764/prognostic-utility-of-meld-xi-in-adult-congenital-heart-disease-patients-undergoing-cardiac-transplantation
#11
Evan D Adams, Nicholas J Jackson, Tim Young, Eugene C DePasquale, Leigh C Reardon
BACKGROUND: Model of End-Stage Liver Disease eXcluding INR (MELD-XI) at cardiac transplant has demonstrated prognostic survival utility, but has not been specifically validated in adult congenital heart disease (ACHD) in a registry study. METHODS: Adults undergoing first-time orthotopic heart transplant from 2005 to 2015 in the United Network for Organ Sharing (UNOS) registry were examined in parallel: ACHD (n = 543), ischemic-dilated cardiomyopathy (IDCM, n = 6954) and valvular heart disease (VHD, n = 355)...
April 16, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29658861/monster-lung-cavity-in-a-heart-transplant-recipient
#12
Brandon T Nokes, Octavio Pajaro, Jenise Stephen, Patrick DeValeria, Robert Scott, Sadia Shah, Eric Steidley, Jama Jahanyar
Invasive mucormycosis infections occur in less than 1% of recipients of orthotopic heart transplants. Given the angioinvasive nature of these infections, the mortality rate is high. Little literature exists regarding the presentation and management of these infections. We present a case of a patient who developed an infection after orthotopic heart transplant, describe the successful multidisciplinary management surrounding his care, and review the available literature regarding mucormycosis infections in heart transplant recipients...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29652681/direct-ultrasound-of-the-pulmonary-artery-helps-diagnose-a-rare-cause-of-right-ventricular-failure-after-heart-transplantation-a-case-report
#13
John S McNeil, Si M Pham, Julie L Huffmyer
Pulmonary artery anastomosis stenosis is a rare cause of right ventricular failure after orthotopic heart transplantation. In this case report, direct ultrasound of the pulmonary artery helped diagnose stenosis at a location not visible on transesophageal echocardiography or even with standard epicardial ultrasound views. It is important to evaluate all vascular anastomoses after heart or lung transplantation because surgical revision of these lesions is facile, but if left undiagnosed, significant morbidity or mortality is likely...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29615436/ttr-transthyretin-stabilizers-are-associated-with-improved-survival-in-patients-with-ttr-cardiac-amyloidosis
#14
Hannah Rosenblum, Adam Castano, Julissa Alvarez, Jeff Goldsmith, Stephen Helmke, Mathew S Maurer
BACKGROUND: TTR (transthyretin) cardiac amyloidosis is caused by dissociation of TTR into monomers, which misassemble into amyloid fibrils. TTR stabilizers act at the dimer-dimer interface to prevent dissociation. We investigated differences in survival among patients with TTR cardiac amyloidosis on stabilizer medications compared with those not on stabilizers. METHODS AND RESULTS: A retrospective study of patients with TTR cardiac amyloidosis presenting to a single center was conducted...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29608499/diagnosis-treatment-and-management-of-orthotopic-liver-transplant-candidates-with-portopulmonary-hypertension
#15
Anna Koulava, Abdallah Sannani, Avi Levine, Chhaya Aggarwal Gupta, Sarina Khanal, William Frishman, Roxana Bodin, David C Wolf, William Aronow, Gregg M Lanier
Portopulmonary hypertension (POPH) is seen in 5-8% of orthotopic liver transplantation (OLT) candidates and has significant implications for clinical outcomes. POPH is characterized by vasoconstriction and remodeling of the pulmonary vasculature. It is exacerbated by the hyperdynamic circulation that is common in advanced liver disease. Screening all OLT candidates with transthoracic echocardiography to assess pulmonary pressures and right ventricular function is crucial, as clinical symptoms alone are not reliable...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29603413/optimal-low-density-lipoprotein-concentration-in-cardiac-allograft-vasculopathy
#16
J R Harris, J J Teuteberg, M A Shullo
Cardiac allograft vasculopathy is a major risk factor influencing graft loss and patient survival following orthotopic heart transplant. Allograft vasculopathy is a multifactorial process which includes both immunologic and non-immunologic mechanisms. Given the non-immunological risk factors for vasculopathy, particularly hyperlipidemia, it is intuitive that reducing a patient's LDL would help attenuate the disease process. Multiple studies have shown benefits with the use of statin therapy. However, current heart transplant guidelines do not give a specific recommendation as to what LDL goal should be achieved in this patient population...
March 30, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29598855/role-of-percutaneous-coronary-intervention-in-the-treatment-of-cardiac-allograft-vasculopathy
#17
Michael S Lee, Gentian Lluri, Will Finch, Kyung Woo Park
We evaluated our quarter-century experience with percutaneous coronary intervention (PCI) in patients with cardiac allograft vasculopathy (CAV). CAV is a progressive form of atherosclerosis that is characterized by diffuse intimal thickening. It is a major cause of morbidity and mortality after orthotopic heart transplantation (OHT). Effective treatment options are limited. PCI has been used as a palliative treatment in selected patients. We retrospectively analyzed 140 patients with CAV who underwent PCI from 1992 to 2017 at the University of California, Los Angeles (UCLA) Medical Center...
February 6, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29587521/orthotopic-heart-transplantation-in-children
#18
Nagarajan Muthialu
Heart transplantation is a relatively infrequent but technically demanding procedure in pediatric cardiac surgery. Orthotopic heart transplantation is often offered to older children or adolescents following multiple previous operations, but with advances in intensive care, diagnostics, and management, more infants with complex congenital heart diseases are being listed for transplantation. Primary cardiomyopathies remain the most common indication. Outcomes following cardiothoracic transplantation have improved steadily in recent times...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29573567/comparison-of-continuous-flow-ventricular-assist-device-therapy-with-intensive-medical-therapy-in-fixed-pulmonary-hypertension-secondary-to-advanced-left-heart-failure
#19
Gayathri Kumarasinghe, Pankaj Jain, Andrew Jabbour, Jacqueline Lai, Anne M Keogh, Eugene Kotlyar, Paul Jansz, Peter S Macdonald, Christopher S Hayward
AIMS: Both ventricular assist device (VAD) and pulmonary vasodilator therapy have been shown in uncontrolled studies to improve pulmonary hypertension secondary to advanced left heart failure (Group 2 PH). This study aimed to compare haemodynamic benefits and survival in patients with fixed Group 2 PH treated with continuous-flow VAD to intensive medical therapy. METHODS AND RESULTS: Ninety-five patients listed for heart transplantation with sequential right heart catheters were studied, 24 patients having fixed Group 2 PH (as defined by cardiac index < 2...
March 24, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29571727/intracardiac-tromboembolism-during-liver-transplantation
#20
S Longo, M Palacios, M E Tinti, J Siri, J I de Brahi, M C Cabrera Shulmeyer
We describe a case of intraoperative cardiac trombosis during orthotopic liver transplant surgery that resulted in intraoperative death. By using transesophageal echocardiography, the cause of the descompensation of the patient could be determined and the mechanism of trombus migration from thrombi from the venous circulation to the left heart was accurately observed.
March 20, 2018: Revista Española de Anestesiología y Reanimación
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