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Orthotopic Heart Transplant

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https://www.readbyqxmd.com/read/28486870/long-term-cardiac-morbidity-and-mortality-in-patients-with-aortic-valve-disease-following-liver-transplantation-a-case-matching-study
#1
Ramona Nicolau-Raducu, Thomas Marshall, Hamang Patel, Kelly Ural, Joseph Koveleskie, Susan Smith, Donald Ganier, Bryan Evans, Brian Fish, William Daly, Ari J Cohen, George Loss, Amjad Bokhari, Bobby Nossaman
INTRODUCTION: This retrospective study examined the role of aortic valve (AV) disease in patients who underwent orthotopic liver transplantation (OLT) to determine the incidence of postoperative cardiac morbidity and mortality when compared with a matched control group without AV disease. METHODS: Patients were included in the AV group if diagnosed with aortic stenosis (AS) or aortic regurgitation or had received AV replacement prior to OLT. The AV group (n = 53) was matched to a control group (n = 212) with the following preoperative variables: type of organ transplanted, age, gender, race, body mass index, MELD, redo-transplantation, preoperative renal replacement therapy, nonalcoholic steatohepatitis, viral hepatitis, diabetes, and coronary artery disease...
May 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28470781/elevated-donor-hemoglobin-a1c-does-not-impair-early-survival-in-cardiac-transplant-recipients
#2
Jeremy T Joseph, Michael S Mulvihill, Babatunde A Yerokun, Sadé M Bell, Carmelo A Milano, Matthew G Hartwig
BACKGROUND: Orthotopic heart transplantation (OHT) is the gold-standard therapy for end-stage heart failure. An increasing deficit between suitable allograft availability and clinical demand for OHT exists. The role of donor diabetes mellitus (DM) on post-transplant recipient outcomes in OHT is controversial. The purpose of this study was to examine donor hemoglobin A1c (HbA1c) levels to identify the impact of donor glycemic control on recipient survival. METHODS: Adult OHT recipients with donor HbA1c data were identified in the UNOS database from 2010-2015...
May 3, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28465499/posterior-reversible-encephalopathy-syndrome-after-orthotopic-heart-transplantation-a-case-report
#3
Rigoberto Ramirez, Preetham Reddy Muskula, Mark P Everley
BACKGROUND Calcineurin inhibitor-induced posterior reversible encephalopathy syndrome (PRES) is well described in liver and kidney transplant patients, but there is a paucity of data in heart transplant patients. PRES syndrome in the setting of heart transplantation can occur as early as 5 days following transplantation. CASE REPORT A 32-year-old woman who had recently undergone orthotopic heart transplantation developed headaches, visual disturbances, and generalized tonic clonic seizures 5 days after initiating anti-rejection therapy (tacrolimus, mycophenolate, and prednisone)...
May 3, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28465118/development-and-validation-of-a-major-adverse-transplant-event-mate-score-to-predict-late-graft-loss-in-pediatric-heart-transplantation
#4
Christopher S Almond, Helena Hoen, Joseph W Rossano, Chesney Castleberry, Scott R Auerbach, Lingyao Yang, Ashwin K Lal, Melanie D Everitt, Matthew Fenton, Seth A Hollander, Elfriede Pahl, Elizabeth Pruitt, David N Rosenthal, Doff B McElhinney, Kevin P Daly, Manisha Desai
BACKGROUND: There is inadequate power to perform a valid clinical trial in pediatric heart transplantation (HT) using a conventional end-point, because the disease is rare and hard end-points, such as death or graft loss, are infrequent. We sought to develop and validate a surrogate end-point involving the cumulative burden of post-transplant complications to predict death/graft loss to power a randomized clinical trial of maintenance immunosuppression in pediatric HT. METHODS: Pediatric Heart Transplant Study (PHTS) data were used to identify all children who underwent an isolated orthotopic HT between 2005 and 2014 who survived to 6 months post-HT...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28461800/bioprosthetic-aortic-valve-replacement-in-a-donor-heart-before-orthotopic-heart-transplantation
#5
Manish Patel, Khashayar K Vahdat, Sriram Nathan, Marija Petrovic, Pranav Loyalka, Biswajit Kar, Igor D Gregoric
Current criteria for donor hearts limit the number of hearts available for transplantation, despite an increasing number of recipients on waiting lists. We report the case of a patient with ischemic cardiomyopathy and refractory ventricular tachycardia who underwent successful orthotopic heart transplantation and concurrent aortic valve replacement with a donor heart that had displayed moderate aortic valve regurgitation. The patient was a 71-year-old man with a history of advanced heart failure, 5-vessel coronary artery bypass grafting, and paroxysmal ventricular tachycardia...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28459983/vasoplegia-after-heart-transplantation-outcomes-at-1-year%C3%A2
#6
Joshua L Chan, Jon A Kobashigawa, Tamar L Aintablian, Yanqing Li, Paul A Perry, Jignesh K Patel, Michelle M Kittleson, Lawrence S Czer, Parham Zarrini, Angela Velleca, Jenna Rush, Francisco A Arabia, Alfredo Trento, Fardad Esmailian
OBJECTIVES: : Vasoplegia syndrome is a potentially life-threatening condition that can occur following cardiopulmonary bypass. Heart transplantation is a recognized risk factor for developing this vasodilatory state. The objective of this study was to determine the effects of vasoplegia syndrome on 1-year heart transplant outcomes. METHODS: : A retrospective review of orthotopic heart transplants at a single institution between November 2010 and December 2014 was performed...
April 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28457697/extended-distance-cardiac-allograft-can-successfully-be-utilized-without-impacting-long-term-survival
#7
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Anjali Owens, Michael A Acker, Pavan Atluri
BACKGROUND: Despite the severe shortage of donor cardiac allografts, the general belief in worse outcomes with donors from prolonged distances has resulted in many centers greatly limiting the acceptable geographic distance of acceptable donors. However, with improvements in allograft preservation, it is likely that distance may be extended without compromising graft integrity. We hypothesized that recipients of appropriately selected allografts from greater distances would have equivalent long-term survival compared with recipients from closer geographic regions...
April 15, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28452970/one%C3%A2-year-survival-of-ambulatory-patients-with-end%C3%A2-stage-heart-failure-the-analysis-of-prognostic-factors
#8
Bożena Szygula-Jurkiewicz, Wioletta Szczurek, Michał Skrzypek, Michał Zakliczyński, Łukasz Siedlecki, Piotr Przybyłowski, Marian Zembala, Mariusz Gąsior
INTRODUCTION    An increasing number of ambulatory patients are placed on orthotopic heart transplantation (OHT) waiting lists, which results in an extended waiting time and a higher mortality rate. OBJECTIVES    The aim of this study was to identify the factors associated with reduced survival during a 1‑year follow‑up in patients with end‑stage heart failure listed for an OHT. PATIENTS AND METHODS    We retrospectively analyzed the data of 221 adult patients, who were accepted for OHT in our institution over a 2‑year period between 2013 and 2014...
April 28, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28431981/ventricular-assist-device-elicits-serum-natural-igg-that-correlates-with-the-development-of-primary-graft-dysfunction-following-heart-transplantation
#9
Sarah B See, Kevin J Clerkin, Peter J Kennel, Feifan Zhang, Matthew P Weber, Kortney J Rogers, Debanjana Chatterjee, Elena R Vasilescu, George Vlad, Yoshifumi Naka, Susan W Restaino, Maryjane A Farr, Veli K Topkara, Paolo C Colombo, Donna M Mancini, P Christian Schulze, Bruce Levin, Emmanuel Zorn
BACKGROUND: Pre-transplant sensitization is a limiting factor in solid-organ transplantation. In heart transplants, ventricular assist device (VAD) implantation has been associated with sensitization to human leukocyte antigens (HLA). The effect of VAD on non-HLA antibodies is unclear. We have previously shown that polyreactive natural antibodies (Nabs) contribute to pre-sensitization in kidney allograft recipients. Here we assessed generation of Nabs after VAD implantation in pre-transplant sera and examined their contribution to cardiac allograft outcome...
March 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28405605/three-dimensional-self-navigated-t2-mapping-for-the-detection-of-acute-cellular-rejection-after-orthotopic-heart-transplantation
#10
Ruud B van Heeswijk, Davide Piccini, Piergiorgio Tozzi, Samuel Rotman, Philippe Meyer, Juerg Schwitter, Matthias Stuber, Roger Hullin
BACKGROUND: T2 mapping is a magnetic resonance imaging technique measuring T2 relaxation time, which increases with the myocardial tissue water content. Myocardial edema is a component of acute cellular rejection (ACR) after heart transplantation. This pilot study compares in heart transplantation recipients a novel high resolution 3-dimensional (3D) T2-mapping technique with standard 2-dimensional (2D) T2-mapping for ACR detection. METHODS: Consecutive asymptomatic patients (n = 26) underwent both 3D T2 mapping and reference 2D T2 mapping magnetic resonance imaging on the day of endomyocardial biopsy (EMB)...
April 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28390683/prognostic-utility-of-right-ventricular-free-wall-strain-in-low-risk-patients-after-orthotopic-heart-transplantation
#11
Amr F Barakat, Brett W Sperry, Randall C Starling, Amgad Mentias, Zoran B Popovic, Brian P Griffin, Milind Y Desai
Global longitudinal strain (GLS) by speckle-tracking echocardiography is a sensitive measure of regional left and right ventricular (LV and RV) dysfunction, before onset of overt systolic dysfunction. We sought to evaluate the prognostic utility of measuring LV-GLS and RV free wall strain (FWS) in low risk patients at 1 year after orthotopic heart transplantation (OHT). We retrospectively studied 96 OHT recipients (age 52 ± 14 years, 64% men) free of antibody-mediated rejection or moderate to severe coronary allograft vasculopathy (CAV, grade 2 to 3) at 1 year after transplant...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28387838/temporary-mechanical-circulatory-support-after-orthotopic-heart-transplantation-a-single-centre-experience
#12
Vakhtang Tchantchaleishvili, Katherine L Wood, Laura A Carlson, Bryan Barrus, Michael F Swartz, Himabindu Vidula, Juan M Lehoux, H Todd Massey, Leway Chen
OBJECTIVES: There are various strategies in the use of temporary mechanical circulatory support following orthotopic heart transplant (OHT). We sought to examine the outcomes following different temporary mechanical circulatory support strategies for acute graft failure. METHODS: Patients who received an OHT between 2001 and 2015 at a single institution were retrospectively reviewed. Patients were divided into 2 groups based on the need for temporary mechanical circulatory support (TMCS)...
April 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28344200/new-onset-diabetes-mellitus-after-heart-transplantation%C3%A3-incidence-risk-factors-and-impact-on-clinical-outcome
#13
Ho Jin Kim, Sung-Ho Jung, Jae-Joong Kim, Tae-Jin Yun, Joon Bum Kim, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
BACKGROUND: New-onset diabetes mellitus (DM) can occur as a serious complication after heart transplantation, but the comparative data on its clinical impact on survival and on transplant-related adverse events are limited.Methods and Results:We reviewed a total of consecutive 391 patients aged ≥17 years undergoing isolated orthotopic heart transplantation at the present institution from 1992 to 2013. The entire cohort was divided into 3 groups: (1) no diabetes (n=257); (2) pre-existing DM (n=46); and (3) new-onset DM (n=88)...
March 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28341356/mortality-risk-stratification-in-fontan-patients-who-underwent-heart-transplantation
#14
Christopher J Berg, Brenton S Bauer, Abbie Hageman, Jamil A Aboulhosn, Leigh C Reardon
The number of patients who require orthotopic heart transplantation (OHT) for failing Fontan physiology continues to grow; however, the methods and tools to evaluate risk of OHT are limited. This study aimed to identify a set of preoperative variables and characteristics that were associated with a greater risk of postoperative mortality in patients who received OHT for failing Fontan physiology. Thirty-six Fontan patients were identified as having undergone OHT at University of California-Los Angeles Medical Center from 1991 to 2014...
May 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28331443/pacemaker-use-following-heart-transplantation
#15
Hari R Mallidi, Michael Bates
BACKGROUND: The incidence of permanent pacemaker implantation after orthotopic heart transplantation has been reported to be 2%-24%. Transplanted hearts usually exhibit sinus rhythm in the operating room following reperfusion, and most patients do not exhibit significant arrhythmias during the postoperative period. However, among the patients who do exhibit abnormalities, pacemakers may be implanted for early sinus node dysfunction but are rarely used after 6 months. Permanent pacing is often required for atrioventricular block...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331331/the-influence-of-surgical-technique-on-early-posttransplant-atrial-fibrillation-comparison-of-biatrial-bicaval-and-total-orthotopic-heart-transplantation
#16
Rasmus Rivinius, Matthias Helmschrott, Arjang Ruhparwar, Christian Erbel, Christian A Gleissner, Fabrice F Darche, Dierk Thomas, Tom Bruckner, Hugo A Katus, Andreas O Doesch
PURPOSE: Early posttransplant atrial fibrillation (AF) has been associated with worse clinical outcomes after heart transplantation (HTX). The type of surgical technique may constitute a relevant risk factor for AF. PATIENTS AND METHODS: This retrospective single-center study included 530 adult patients. Patients were stratified by surgical technique (biatrial, bicaval, or total orthotopic HTX) and early posttransplant heart rhythm (AF or sinus rhythm). Univariate and multivariate analyses were performed to evaluate risk factors for AF...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28296050/a-heart-within-a-heart
#17
Edward T Carreras, Maya Barghash, Michael M Givertz, Deepak L Bhatt
A 44-year-old man with a history of end-stage dilated cardiomyopathy status-post orthotopic cardiac transplant 14 years ago presented for coronary angiography in preparation for re-operative tricuspid valve replacement. Coronary angiography revealed an anomalous origin of the left coronary artery, with a common coronary trunk arising from the right coronary cusp and bifurcating into right and left main coronary arteries. Interestingly, the right and left coronary arteries coursed to form the shape of a heart, hence, a heart within a heart! © 2017 Wiley Periodicals, Inc...
March 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28290973/total-artificial-heart-implantation-as-a-bridge-to-heart-transplantation-in-an-active-duty-service-member-with-amyloid-cardiomyopathy
#18
Michael S Scully, Dylan E Wessman, James M McKee, Gregory M Francisco, Keshav R Nayak, Jon A Kobashigawa
INTRODUCTION: Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289529/optimal-timing-of-same-admission-orthotopic-heart-transplantation-after-left-ventricular-assist-device-implantation
#19
Gunsagar Gulati, David Ouyang, Richard Ha, Dipanjan Banerjee
AIM: To investigate the impact of timing of same-admission orthotopic heart transplant (OHT) after left ventricular assist device (LVAD) implantation on in-hospital mortality and post-transplant length of stay. METHODS: Using data from the Nationwide Inpatient Sample from 1998 to 2011, we identified patients 18 years of age or older who underwent implantation of a LVAD and for whom the procedure date was available. We calculated in-hospital mortality for those patients who underwent OHT during the same admission as a function of time from LVAD to OHT, adjusting for age, sex, race, household income, and number of comorbid diagnoses...
February 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28285802/long-term-prognosis-and-cost-effectiveness-of-left-ventricular-assist-device-as-bridge-to-transplantation-a-systematic-review
#20
Michael Seco, Dong Fang Zhao, Michael J Byrom, Michael K Wilson, Michael P Vallely, John F Fraser, Paul G Bannon
BACKGROUND: This systematic review aimed to evaluate the clinical outcomes and cost-effectiveness of left ventricular assist devices (LVADs) used as bridge to transplantation (BTT), compared to orthotopic heart transplantation (OHT) without a bridge. METHOD: Systematic searches were performed in electronic databases with available data extracted from text and digitized figures. Meta-analysis of short and long-term term post-transplantation outcomes was performed with summation of cost-effectiveness analyses...
May 15, 2017: International Journal of Cardiology
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