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Orthotopic Heart Transplant

J Trent Magruder, Joshua C Grimm, Todd C Crawford, Ryan J Tedford, Stuart D Russell, Christopher M Sciortino, Glenn J R Whitman, Ashish S Shah
BACKGROUND: Our objective was to determine whether the choice of a HeartWare HVAD as opposed to a Heartmate II left ventricular assist device (HMII LVAD), impacts survival after heart transplantation after controlling for patient, donor, and center characteristics. METHODS: We queried the United Network for Organ Sharing (UNOS) database, which has recently made pretransplantation device duration available, for all adult patients undergoing bridge to transplantation (BTT) between January 2011 and March 2016...
October 17, 2016: Annals of Thoracic Surgery
Anton M Kolomeyer, Ken K Nischal, Ellen Mitchell
PURPOSE: To report a case of bilateral cavernous sinus thrombosis (CST) in a patient with tacrolimus-associated posttransplant thrombotic microangiopathy. METHODS: Case report. RESULTS: An 8-year-old boy with a medical history of orthotopic heart transplant, posttransplant lymphoproliferative disease, and recurrent infections was hospitalized for nausea, vomiting, and diarrhea. His ocular history included accommodative esotropia, hyperopia with astigmatism, Molluscum contagiosum lid lesions, and idiopathic intracranial hypertension...
October 13, 2016: European Journal of Ophthalmology
Dipesh K Shah, Salil V Deo, Andrew D Althouse, Jeffery J Teuteberg, Soon J Park, Robert L Kormos, Harold M Burkhart, Victor O Morell
BACKGROUND: Adults with congenital heart disease may present with end-stage heart failure necessitating orthotopic heart transplant (OHT). We sought to review the United Network for Organ Sharing (UNOS) experience with this unique cohort focusing on surgical outcomes and survival. METHODS: From the UNOS registry, 737 adult congenital heart disease recipients (ACHDR) out of 26,993 OHT patients (2.7%) who underwent OHT were studied to analyze early and late outcomes and compared to non-congenital recipients (NCR) over a 15-year period (2000-2014)...
October 5, 2016: Journal of Cardiac Surgery
Jose V Venero, Mark Doyle, Moneal Shah, Vikas K Rathi, June A Yamrozik, Ronald B Williams, Diane A Vido, Geetha Rayarao, Raymond Benza, Srinivas Murali, Jerry Glass, Peter Olson, George Sokos, Robert W W Biederman
BACKGROUND: Patients with newly diagnosed dilated cardiomyopathy (DCM) and advanced heart failure have a very high morbidity and mortality with an unpredictable clinical course. We investigated the role of cardiovascular magnetic resonance (CMR) imaging using late gadolinium enhancement (LGE) in this cohort of high-risk patients. We hypothesized that LGE has high prognostic value in primary DCM patients referred for possible transplantation/left ventricular assist device (LVAD) consideration...
December 2015: ESC Heart Failure
Tomasz K Podobinski, Paolo C Mimbella, King S Cachola, Monica Verduzco-Gutierrez
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Ana Rocha, Luísa Lobato
Orthotopic liver transplantation (LT) was implemented as the inaugural disease-modifying therapy for hereditary transthyretin (ATTR) amyloidosis, a systemic amyloidosis mainly affecting the peripheral nervous system and heart. The first approach to pharmacologic therapy was focused on the stabilization of the TTR tetramer; following that new advent LT was assumed as the second step of treatment, for those patients whose neuropathy becomes worse after a course of pharmacologic therapy. The renal disease has been ignored in hereditary ATTR amyloidosis...
September 14, 2016: Transplantation Reviews
Mélanie Métrich, Fortesa Mehmeti, Helene Feliciano, David Martin, Julien Regamey, Piergiorgio Tozzi, Philippe Meyer, Roger Hullin
BACKGROUND: Maximal exercise capacity after heart transplantion (HTx) is reduced to the 50-70% level of healthy controls when assessed by cardiopulmonary exercise testing (CPET) despite of normal left ventricular function of the donor heart. This study investigates the role of donor heart β1 and β2- adrenergic receptor (AR) polymorphisms for maximal exercise capacity after orthotopic HTx. METHODS: CPET measured peak VO2 as outcome parameter for maximal exercise in HTx recipients ≥9 months and ≤4 years post-transplant (n = 41; mean peak VO2: 57±15% of predicted value)...
2016: PloS One
Roosevelt Bryant, Farhan Zafar, Chesney Castleberry, John L Jefferies, Angela Lorts, Clifford Chin, David L S Morales
The Berlin Heart EXCOR pediatric ventricular assist device is approved by the FDA for bridge to cardiac transplantation (BTT) in children. As the clinical outcomes of the EXCOR continue to be evaluated in the U.S., data on post transplant survival are needed. The UNOS database was used to identify patients < 18 years old undergoing orthotopic heart transplantation (OHT) from 6/2004 to 6/2014. Patients undergoing BTT with the EXCOR were identified. A matched cohort of (358) patients undergoing OHT without pre-transplant mechanical circulatory support (no-MCS) was also identified as controls...
September 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Garry R Thomas, Michael A McDonald, Jennifer Day, Heather J Ross, Diego H Delgado, Filio Billia, Jagdish W Butany, Vivek Rao, Eitan Amir, Philippe L Bedard, Paaladinesh Thavendiranathan
Anthracycline-induced cardiomyopathy (AIC) may progress to end-stage heart failure requiring mechanical circulatory support or orthotopic heart transplantation (OHT). Previous studies have described important clinical differences between AIC and nonischemic cardiomyopathy (NIC) cohorts requiring these advanced interventions. Therefore, we sought to extend this literature by comparing echocardiographic parameters, treatment strategies, and the prognosis between matched patients from these cohorts. This is a retrospective matched cohort study...
August 23, 2016: American Journal of Cardiology
J Trent Magruder, William Plum, Todd C Crawford, Joshua C Grimm, Marvin C Borja, Ronald D Berger, Harikrishna Tandri, Hugh Calkins, Duke E Cameron, Kaushik Mandal
BACKGROUND: We compared the incidence of late-onset atrial fibrillation in orthotopic heart transplant recipients and bilateral orthotopic lung transplant recipients. METHODS: We reviewed the records of all heart and lung transplant operations carried out in our institution between 1995 and 2015. We performed 1:1 propensity-matching based on patient age, sex, body mass index, and hypertension. Our primary outcome, late-onset atrial fibrillation, was defined as atrial fibrillation occurring after discharge following hospitalization for transplantation...
September 15, 2016: Asian Cardiovascular & Thoracic Annals
Dmitry Tumin, Randi E Foraker, Sakima Smith, Joseph D Tobias, Don Hayes
BACKGROUND: Health insurance status at heart transplantation influences recipient survival, but implications of change in insurance for long-term outcomes are unclear. METHODS AND RESULTS: Adults aged 18 to 64 receiving first-time orthotopic heart transplants between July 2006 and December 2013 were identified in the United Network for Organ Sharing registry. Patients surviving >1 year were categorized according to trajectory of insurance status (private compared with public) at wait listing, transplantation, and 1-year follow-up...
September 2016: Circulation. Cardiovascular Quality and Outcomes
Patrizia Pedrotti, Claudia Vittori, Rita Facchetti, Stefano Pedretti, Santo Dellegrottaglie, Angela Milazzo, Maria Frigerio, Manlio Cipriani, Cristina Giannattasio, Alberto Roghi, Ornella Rimoldi
AIMS: The aim of the present study was to assess the association of the presence and amount of late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) with cardiovascular adverse events in patients with orthotopic heart transplantation (HTx). METHODS AND RESULTS: We enrolled 48 patients (mean age, 54.7 ± 14.6 years; 37 men) at various stages after HTx. All patients underwent standard CMR at 1.5 T, to characterize both cardiac anatomy and LGE. Late gadolinium enhancement was detected in 26 patients (54%)...
September 13, 2016: European Heart Journal Cardiovascular Imaging
J T Magruder, A S Shah, T C Crawford, J C Grimm, B Kim, J B Orens, E L Bush, R S Higgins, C A Merlo
We simulated the impact of regionalization of isolated heart and lung transplantation within United Network for Organ Sharing (UNOS) regions. Overall, 12 594 orthotopic heart transplantation (OHT) patients across 135 centers and 12 300 orthotopic lung transplantation (OLT) patients across 67 centers were included in the study. An algorithm was constructed that "closed" the lowest volume center in a region and referred its patients to the highest volume center. In the unadjusted analysis, referred patients were assigned the highest volume center's 1-year mortality rate, and the difference in deaths per region before and after closure was computed...
September 12, 2016: American Journal of Transplantation
Sonia Ferretto, Elvin Tafciu, Immacolata Giuliani, Giuseppe Feltrin, Tomaso Bottio, Antonio Gambino, Angela Fraiese, Sabino Iliceto, Gino Gerosa, Loira Leoni
BACKGROUND: Causes and significance of interventricular conduction disorders (IVCDs) after orthotopic heart transplantation (OHT) are still unknown. METHODS: We retrospectively researched the presence of IVCDs in 240 patients who underwent bicaval OHT in three time periods: at day 1, after 1 year, and after 3 years from OHT. To evaluate the impact of the surgical technique, a control population treated with biatrial anastomosis was used. RESULTS: The most common IVCD was right bundle branch block (RBBB)...
September 9, 2016: Annals of Noninvasive Electrocardiology
Hythem M Nawaytou, Putri Yubbu, Andrea E Montero, Deipanjan Nandi, Matthew J O'Connor, Robert E Shaddy, Anirban Banerjee
BACKGROUND: Left ventricular (LV) dysfunction after orthotopic heart transplantation (OHT) is multifactorial and can be an indicator of graft rejection or coronary artery vasculopathy. Analysis of rotational mechanics may help in the early diagnosis of ventricular dysfunction. Studies describing the left ventricular rotational strain in children after OHT are lacking. It is important to establish the baseline rotational mechanics in pediatric OHT to pursue further studies in this population...
September 2016: Circulation. Cardiovascular Imaging
Diego Pérez Díez, David Calvo Cuervo, José Manuel Rubín, Beatriz Díaz Molina, José Luis Lambert, César Morís de la Tassa
No abstract text is available yet for this article.
August 17, 2016: Revista Española de Cardiología
Eliza W Beal, Khalid Mumtaz, Don Hayes, Bryan A Whitson, Sylvester M Black
Combined heart-liver transplantation is a rare, life-saving procedure that treats complex and often fatal diseases including familial amyloidosis polyneuropathy and late stage congenital heart disease status-post previous repair. There were 159 combined heart-liver transplantations performed between January 1, 1988 and October 3, 2014 in the United States. A multitude of potential techniques to be used for combined heart and liver transplant including: orthotopic heart transplant (OHT) and orthotopic liver transplant (OLT) on full cardiopulmonary bypass (CPB), OHT with CPB and OLT with venovenous bypass (VVB), OHT with CPB and OLT without VVB, en-bloc technique and sequential transplantation...
October 2016: Transplantation Reviews
Lauren B Cooper, Robert J Mentz, Leah B Edwards, Amber R Wilk, Joseph G Rogers, Chetan B Patel, Carmelo A Milano, Adrian F Hernandez, Josef Stehlik, Lars H Lund
BACKGROUND: Pre-transplant amiodarone use has been postulated as a risk factor for morbidity and mortality after orthotopic heart transplantation (OHT). We assessed pre-OHT amiodarone use and tested the hypothesis that it is associated with impaired post-OHT outcomes. METHODS: We performed a retrospective cohort analysis of adult OHT recipients from the registry of the International Society for Heart and Lung Transplantation (ISHLT). All patients had been transplanted between 2005 and 2013 and were stratified by pre-OHT amiodarone use...
July 17, 2016: Journal of Heart and Lung Transplantation
Samuel R Schnittman, Saima Rashid, Alexander Egbe, Barry Love, Khanh Nguyen, Alexander J C Mittnacht, Aaron J Weiss
Based on described benefits of fast-tracking and early extubation in children undergoing congenital heart surgery, we applied this concept to selected children following uncomplicated orthotopic heart transplantation (OHT). In this case series, we report four patients who were extubated immediately after surgery in the operating room. A mild respiratory acidosis and hypercapnia were noted on the initial arterial blood gases, were well tolerated, and were normalized within 6 to 12 hours. There was no mortality among patients who were extubated in the operating room, and no patients required reintubation...
August 11, 2016: World Journal for Pediatric & Congenital Heart Surgery
Ali Abbas, Ahmed Mahmoud, Mustafa Ahmed, Juan Aranda, Charles T Klodell, Peter V Draganov
BACKGROUND: Gastrointestinal bleeding (GIB) is a common adverse event after mechanical circulatory support device implantation. However, the majority of the reported data were obtained from small single-center studies. Our aim was to study the prevalence and predictors of GIB during the index hospitalization of mechanical circulatory support devices implantation using a nationwide database. METHODS: Nationwide inpatient sample (2009-2011) was used to perform a retrospective cross-sectional study...
August 10, 2016: Digestive Diseases and Sciences
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