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Orthotopic Heart Transplant

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https://www.readbyqxmd.com/read/28879059/pulmonary-hypertension-and-cardiac-hypertrophy-in-children-recipients-of-orthotopic-living-related-liver-transplantation
#1
Magd A Kotb, Inas Abd El Satar, Ahmed M Badr, Nancy H Anis, Hoda Abd El Rahman Ismail, Alaa F Hamza, Hesham M Abdelkader
Surgical stress, liberation of cytokines associated with re-perfusion injury, and long standing use of immune suppressive medications in children recipients of orthotopic living related liver transplantation (OLRLT) pose cardiovascular risk. Reported cardiovascular adverse effects vary from left ventricular wall thickening, hypertrophic cardiomyopathy to resting ECG abnormalities, asymptomatic ST depression following increased heart rate and ventricular arrhythmias. Twenty-five consecutive children recipients of OLRLT were assessed by conventional 2-D, M-mode echocardiography and Doppler...
November 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28878572/dabigatran-reversal-with-idarucizumab-in-a-patient-undergoing-heart-transplantation-first-european-report
#2
António Tralhão, Carlos Aguiar, Jorge Ferreira, Maria José Rebocho, Emília Santos, Dinis Martins, José Pedro Neves
BACKGROUND: Dabigatran is a direct thrombin inhibitor with a favorable effectiveness and safety profile when compared to vitamin K antagonists, both in randomized trials and real world registries of atrial fibrillation patients. Yet, physicians' fear of high bleeding risk scenarios in daily clinical practice still precludes a more widespread use of oral anticoagulation. We hereby report a successful case of dabigatran reversal with the novel monoclonal antibody fragment idarucizumab in a patient undergoing heart transplantation...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28865557/multimodality-noninvasive-imaging-in-the-monitoring-of-pediatric-heart-transplantation
#3
REVIEW
Steven J Kindel, Hao H Hsu, Tarique Hussain, Jonathan N Johnson, Colin J McMahon, Shelby Kutty
Orthotopic heart transplantation is a well-established and effective therapeutic option for children with end-stage heart failure. Multiple modalities, including noninvasive cardiac imaging, cardiac catheterization, angiography, and endomyocardial biopsy, are helpful to monitor these patients for graft dysfunction, rejection, and vasculopathy. Because of morbidities associated with invasive monitoring, noninvasive imaging plays a key role in the surveillance and evaluation of symptoms in pediatric transplant recipients...
September 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28857926/postpartum-donor-heart-atrial-tachycardia-very-late-after-orthotopic-cardiac-transplantation
#4
Valerio Zacà, Rosaria Gaddi, Claudia Baiocchi, Marina Mercurio, Roberto Favilli
No abstract text is available yet for this article.
October 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28841580/durable-biventricular-support-using-right-atrial-placement-of-the-heartware-hvad
#5
Hao A Tran, Travis L Pollema, Jorge Silva Enciso, Barry H Greenberg, Denise D Barnard, Eric D Adler, Victor G Pretorius
Patients with Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) levels 1-2 who either have or are at risk for right ventricular failure face significant morbidity and mortality after continuous flow left ventricular assist device (CF-LVAD) implantation. Currently, the options for biventricular support are limited the Total Artificial Heart (TAH; CardioWest, Syncardia, Tuscon, AZ) or biventricular assist device (BiVAD), which uses bulky extracorporeal or implantable displacement pumps...
August 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28831661/bariatric-surgery-is-gaining-ground-as-treatment-of-obesity-after-heart-transplantation-report-of-two-cases
#6
Levan Tsamalaidze, Enrique F Elli
Experience with bariatric surgery in patients after orthotopic heart transplantation (OHT) is still limited. We performed a retrospective review of patients who underwent bariatric surgery after OHT from January 1, 2010 to December 31, 2016. Two post-OHT patients with BMI of 37.5 and 36.2 kg/m² underwent laparoscopic robotic-assisted Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy, respectively. Quality of life substantially improved for both patients. Bariatric surgery is safe and feasible in OHT patients, despite numerous risk factors...
August 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28801074/rational-heart-transplant-from-hepatitis-c-donor-new-antiviral-weapons-conquer-the-trojan
#7
Robert L Gottlieb, Teena Sam, Suzanne Y Wada, James F Trotter, Sumeet K Asrani, Brian Lima, Susan M Joseph, Gonzalo Gonzalez-Stawinski, Shelley A Hall
BACKGROUND: Donors with hepatitis C (HCV) viremia are rarely utilized for orthotopic heart transplantation (OHTx) due to post-transplant risks. New, highly effective HCV antivirals may alter the landscape. METHODS: An adult patient unsuitable for bridging mechanical support therapy accepted a heart transplant offer from a donor with HCV viremia. Upon daily logarithmic rise in HCV viral load and adequate titers to ensure successful genotyping, once daily sofosbuvir 400 mg / velpatasvir 100 mg (Epclusa) was initiated empirically pending HCV genotype (genotype 3a confirmed after initiation of therapy)...
August 8, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28781013/early-aspirin-use-and-the-development-of-cardiac-allograft-vasculopathy
#8
Miae Kim, Brian A Bergmark, Thomas A Zelniker, Mandeep R Mehra, Garrick C Stewart, Deborah S Page, Erica L Woodcome, Jennifer A Smallwood, Steven Gabardi, Michael M Givertz
BACKGROUND: Cardiac allograft vasculopathy (CAV) remains a leading cause of morbidity and mortality after orthotopic heart transplantation (OHT). Little is known about the influence of aspirin on clinical expression of CAV. METHODS: We followed 120 patients with OHT at a single center for a median of 7 years and categorized them by the presence or absence of early aspirin therapy post-transplant (aspirin treatment ≥6 months in the first year). The association between aspirin use and time to the primary end-point of angiographic moderate or severe CAV (International Society for Heart and Lung Transplantation grade ≥2) was investigated...
July 3, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28772029/ace-inhibitor-associated-intestinal-angioedema-in-orthotopic-heart-transplantation
#9
Dushyanth Srinivasan, Garth W Strohbehn, Thomas Cascino
Angiotensin-converting enzyme inhibitor induced angioedema commonly involves the head and neck area. We report a case of angiotensin-converting enzyme inhibitor induced intestinal angioedema in a heart transplant recipient on mTOR immunosuppression. A 36-year-old Caucasian woman with history of heart transplantation on sirolimus, tacrolimus and prednisone presented to the Emergency Department with abdominal pain, one day following lisinopril initiation. A computer tomography scan demonstrated diffuse bowel wall thickening consistent with pancolitis and edema...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28761402/posterior-reversible-encephalopathy-syndrome-after-heart-transplantation-diagnosis-and-immunosuppressive-therapy
#10
Aniruddh Kapoor, Emma Birks, Andrew Lenneman, Kelly McCants
Posterior reversible encephalopathy syndrome, an infrequent neurotoxicity associated with the use of tacrolimus, was first described in 1996, as a reversible syndrome manifested by headache, altered mental function, seizures, and visual disturbances. We describe the case of a 37-year-old woman who developed neurologic symptoms consistent with encephalopathy after treatment with tacrolimus, which was prescribed to maintain immunosuppression after orthotopic heart transplantation. This report also discusses the imaging methods used in the diagnosis of posterior reversible encephalopathy and highlights the difficulty of maintaining immunosuppression and managing medication-related adverse effects, while taking into account the risk of acute rejection after transplantation...
June 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28760213/retained-cardiac-implantable-electronic-device-fragments-are-not-associated-with-magnetic-resonance-imaging-safety-issues-morbidity-or-mortality-after-orthotopic-heart-transplant
#11
Christopher O Austin, Kevin Landolfo, Pragnesh P Parikh, Parag C Patel, K L Venkatachalam, Fred M Kusumoto
BACKGROUND: Cardiac implantable electronic device therapy (CIED) has revolutionized treatment for advanced heart failure. Most patients considered for orthotopic heart transplantation (OHT) are treated with implantable cardioverter defibrillators, cardiac resynchronization therapy, or both. These CIEDs are surgically extracted at the time of transplant. Occasionally, CIEDs are incompletely removed. Little is known about the outcomes of post-OHT patients with retained CIED fragments. METHODS: We identified 200 consecutive patients that underwent OHT at our institution between April 2006 and December 2014 and performed a retrospective analysis of available radiographic images and clinical records...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28743270/pre-transplant-depression-as-a-predictor-of-adherence-and-morbidities-after-orthotopic-heart-transplantation
#12
Maja Delibasic, Burhan Mohamedali, Nikola Dobrilovic, Jaishankar Raman
BACKGROUND: Psychosocial factors are useful predictors of adverse outcomes after solid organ transplantation. Although depression is a known predictor of poor outcomes in patients who undergo orthotopic heart transplantation (OHT) and is actively screened for during pre-transplant evaluation, the effects of early identification of this entity on post-transplant outcomes are not clearly understood. The purpose of this study was to evaluate the impact of pre-transplant depression on outcomes after OHT...
July 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28710785/effect-of-thyroid-hormone-on-cardiac-function-following-orthotopic-heart-transplantation-in-piglets
#13
T K Susheel Kumar, Craig Mathis, Shyam Sathanandam, David Zurakowski, Saradha Subramanian, Jerry Allen, Michael Solimine, Lindsay Berrios, Scott Jackson, Mark Landers, Ryan Sullivan, Stacey Barnett, Mark Rayburn, Christopher Loftis, Lauren Price, James B Tansey, Deepthi Hoskoppal, Christopher Knott-Craig
Studies in adult HT have demonstrated improved cardiac function in the recipient following administration of T3 to the donor. The purpose of this experiment was to assess the effects of T3 on the function of the immature donor heart following HT in a piglet model. A total of 32 piglets were divided into 16 donors and 16 recipients. Following creation of brain death, half of the donor piglets were randomized to receive three doses of T3 (0.2 μg/kg) along with hydrocortisone (1 mg/kg). The donor hearts were then transplanted into the recipient piglets on CPB...
September 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28706871/tricuspid-valve-regurgitation-after-heart-transplantation
#14
Murray H Kwon, Richard J Shemin
Tricuspid valve regurgitation (TVR) in the orthotopic heart transplant (OHT) recipient is quite common and has varied clinical sequelae. In its severest forms, it can lead to right-sided failure symptoms indistinguishable from that seen in native heart TVR disease. While certain implantation techniques are widely recognized to reduce the risk of TVR in the cardiac allograft, concomitant tricuspid annuloplasty, while having advocates, is not currently accepted as a routinely established adjunct. Decisions to surgically correct TVR in the OHT recipient must be made carefully, as certain clinical scenarios have high risk of failure...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28706864/surgical-outcomes-of-isolated-tricuspid-valve-procedures-repair-versus-replacement
#15
Julius I Ejiofor, Robert C Neely, Maroun Yammine, Siobhan McGurk, Tsuyoshi Kaneko, Marzia Leacche, Lawrence H Cohn, Prem S Shekar
BACKGROUND: Isolated tricuspid valve (ITV) operations are infrequent and the decision to operate is controversial. We report a series of ITV operations to outline the current disease status requiring this uncommon procedure with an emphasis on the results of tricuspid valve repair (TVr) versus replacement (TVR). METHODS: Using our prospective cardiac surgery database, 57 patients who underwent ITV operations between 01/02-03/14 were identified. Median follow up time was 3...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28703300/a-point-based-prediction-model-for-cardiovascular-risk-in-orthotopic-liver-transplantation-the-car-olt-score
#16
Lisa B VanWagner, Hongyan Ning, Maureen Whitsett, Josh Levitsky, Sarah Uttal, John T Wilkins, Michael M Abecassis, Daniela P Ladner, Anton I Skaro, Donald M Lloyd-Jones
Cardiovascular disease (CVD) complications are important causes of morbidity and mortality after orthotopic liver transplantation (OLT). There is currently no preoperative risk assessment tool that allows physicians to estimate the risk for CVD events following OLT. We sought to develop a point-based prediction model (risk score) for CVD complications after OLT, the CAR-OLT risk score, among a cohort of 1024 consecutive patients aged 18-75 years who underwent first OLT in a tertiary-care teaching hospital (2002-2011)...
July 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28672061/thalidomide-treatment-prevents-chronic-graft-rejection-after-aortic-transplantation-in-rats
#17
Katharine K Miller, Dong Wang, Xiaomeng Hu, Xiaoqin Hua, Tobias Deuse, Evgenios Neofytou, Thomas Renne, Joachim Velden, Hermann Reichenspurner, Sonja Schrepfer, Daniel Bernstein
BACKGROUND: Cardiac allograft vasculopathy (CAV) affects approximately 30% of cardiac transplant patients at five years post-transplantation. To date there are few CAV treatment or prevention options, none of which are highly effective. The aim of the study was to investigate the effect of thalidomide on the development of CAV. METHODS: The effect of thalidomide treatment on chronic rejection was assessed in rat orthotopic aortic transplants in allogeneic F344 or syngeneic Lew rats (n=6/group)...
July 3, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28671171/early-onset-de-novo-invasive-pulmonary-aspergillosis-in-an-orthotopic-heart-transplant-recipient
#18
Zaw Min, Manik Veer, Parth Rali, Anil Singh, Nitin Bhanot
Invasive aspergillosis generally occurs during the first 1-6 months after heart transplantation. It has been rarely seen in the first 2 weeks postcardiac transplant. We herein describe a unique case of invasive pulmonary aspergillosis (IPA) diagnosed on day 9 postorthotopic heart transplantation. The known risk factors for IPA in cardiac transplant recipients were not identified in our case. The organ recipients from the same donor did not report Aspergillus infection. Hospital environmental samplings failed to demonstrate Aspergillus spores in the patient's room and his adjacent rooms...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28670701/diarrhea-an-uncommon-presentation-of-tertiary-adrenal-insufficiency-following-heart-transplantation
#19
Saad Sikanderkhel, M Waqas Choudhry, Vincent Valentine, Ghannam Al-Dossari, Wissam I Khalife
Diarrhea following organ transplantation is usually associated with infection and immunosuppression therapy. We describe two patients with diarrhea following orthotopic heart transplantation due to tertiary adrenal insufficiency.
August 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28651907/tumor-necrosis-factor-%C3%AE-levels-and-non-surgical-bleeding-in-continuous-flow-left-ventricular-assist-devices
#20
Corey E Tabit, Mitchell J Coplan, Phetcharat Chen, Valluvan Jeevanandam, Nir Uriel, James K Liao
BACKGROUND: Non-surgical bleeding (NSB) due to angiodysplasia is common in left ventricular assist device (LVAD) patients. Thrombin-induced angiopoietin-2 (Ang-2) expression in LVAD patients leads to altered angiogenesis and is associated with lower angiopoietin-1 (Ang-1) and increased NSB. However, the mechanism for decreased Ang-1, made by pericytes, is unknown and the origin of thrombin in LVAD patients is unclear. We hypothesized that high tumor necrosis factor-α (TNF-α) levels in LVAD patients induce pericyte apoptosis, tissue factor (TF) expression and vascular instability...
June 8, 2017: Journal of Heart and Lung Transplantation
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