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Heart transplant review

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https://www.readbyqxmd.com/read/28088844/role-of-contrast-ct-for-the-diagnosis-and-the-prognosis-of-suspected-lvad-thrombosis
#1
Bill C Tran, Prabhjot S Nijjar
BACKGROUND: There is an urgent need for further studies evaluating the role of imaging modalities in the management of left ventricular assist device (LVAD) thrombosis. This study reviews the role of computed tomography (CT) in the diagnosis of suspected LVAD thrombosis. METHODS: All contrast chest CTs performed in patients with suspected LVAD thrombosis at the University of Minnesota between January 2008 and April 2014 were reviewed. Significant CT findings were identified, operative notes were reviewed, and patient outcomes were reported...
January 15, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28087362/clinical-phenotypes-and-outcomes-of-heritable-and-sporadic-pulmonary-veno-occlusive-disease-a-population-based-study
#2
David Montani, Barbara Girerd, Xavier Jaïs, Marilyne Levy, David Amar, Laurent Savale, Peter Dorfmüller, Andrei Seferian, Edmund M Lau, Mélanie Eyries, Jérôme Le Pavec, Florence Parent, Damien Bonnet, Florent Soubrier, Elie Fadel, Olivier Sitbon, Gérald Simonneau, Marc Humbert
BACKGROUND: Bi-allelic mutations of the EIF2AK4 gene cause heritable pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis (PVOD/PCH). We aimed to assess the effect of EIF2AK4 mutations on the clinical phenotypes and outcomes of PVOD/PCH. METHODS: We did a population-based study using clinical, functional, and haemodynamic data from the registry of the French Pulmonary Hypertension Network. We reviewed the clinical data and outcomes from all patients referred to the French Referral Centre (Pulmonary Department, Hospital Kremlin-Bicêtre, University Paris-Sud) with either confirmed or highly probable PVOD/PCH with DNA available for mutation screening (excluding patients with other risk factors of pulmonary hypertension, such as chronic respiratory diseases)...
January 10, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28067969/disseminated-acanthamoeba-infection-in-a-heart-transplant-recipient-treated-successfully-with-a-miltefosine-containing-regimen-case-report-and-review-of-the-literature
#3
Max N Brondfield, Michael J A Reid, Rachel L Rutishauser, Jennifer R Cope, Jevon Tang, Jana M Ritter, Almea Matanock, Ibne Ali, Sarah B Doernberg, Alexandra Hilts-Horeczko, Teresa DeMarco, Liviu Klein, Jennifer M Babik
Disseminated acanthamoebiasis is a rare, often fatal, infection most commonly affecting immunocompromised patients. We report a case involving sinuses, skin, and bone in a 60-year-old woman 5 months after heart transplantation. She improved with a combination of flucytosine, fluconazole, miltefosine, and decreased immunosuppression. To our knowledge, this is the first case of successfully treated disseminated acanthamoebiasis in a heart transplant recipient and only the second successful use of miltefosine for this infection among solid organ transplant recipients...
January 9, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28063864/the-end-of-life-experience-of-pediatric-heart-transplant-recipients
#4
Seth A Hollander, John Dykes, Sharon Chen, Lynsey Barkoff, Barbara Sourkes, Harvey Cohen, David N Rosenthal, Daniel Bernstein, Beth D Kaufman
CONTEXT: Despite advances in therapies, many pediatric heart transplant (Htx) recipients will die prematurely. We characterized the circumstances surrounding death in this cohort, including location of death and interventions performed in the final 24 hours. METHODS: We reviewed all patients who underwent Htx at Lucile Packard Children's Hospital, Stanford, survived hospital discharge, and subsequently died between 7/19/2007-9/13/2015. The primary outcome studied was location of death, characterized as inpatient, outpatient, or emergency department (ED)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28058224/persistent-epstein-barr-viral-load-in-epstein-barr-viral-na%C3%A3-ve-pediatric-heart-transplant-recipients-risk-of-late-onset-post-transplant-lymphoproliferative-disease
#5
Bibhuti Das, Robert Morrow, Rong Huang, David Fixler
AIM: To examine the risk of late-onset post-transplant lymphoproliferative disorder (PTLD) in the presence of persisting high Epstein-Barr virus (EBV) in EBV naïve pediatric heart transplant (HT) recipients. METHODS: A retrospective review of the medical records of the 145 pediatric HT recipients who had serial EBV viral load monitoring at our center was performed. We defined EBV naive patients whose EBV serology either IgM or IgG in the blood were negative at the time of HT and excluded passive transmission from mother to child in subjects less than 6 mo of age...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28057809/factors-associated-with-long-term-mortality-after-fontan-procedures-a-systematic-review
#6
REVIEW
Tarek Alsaied, Jouke P Bokma, Mark E Engel, Joey M Kuijpers, Samuel P Hanke, Liesl Zuhlke, Bin Zhang, Gruschen R Veldtman
BACKGROUND: Despite an ageing Fontan population, data on late outcomes are still scarce. Reported outcome measures and determinants vary greatly between studies making comprehensive appraisal of mortality hazard challenging. METHODS: We conducted a systematic review to evaluate causes and factors associated with late mortality in patients with Fontan circulation. Late mortality was defined as mortality beyond the first postoperative year. Studies were included if they had ≥90 patients or ≥20 late mortalities and/or transplants...
January 15, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28043470/single-center-experience-with-the-senning-procedure-in-the-current-era
#7
Giuseppe Ferro, Raghav Murthy, Vinod A Sebastian, Kristine J Guleserian, Joseph M Forbess
The Senning procedure is an operative technique for atrial inversion in congenital heart anomalies. We sought to evaluate our contemporary outcomes employing this technique. A retrospective analysis of all patients who underwent the Senning procedure at our institution was performed. Hospital records were reviewed, and follow-up data were obtained to evaluate outcomes. Overall, a total of 19 patients underwent a Senning procedure between August 2005 and July 2014. Median age at repair was 594 days (range: 5 days to 15 years)...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043466/increasing-complexity-of-heart-transplantation-in-patients-with-congenital-heart-disease
#8
William Y Shi, Pankaj Saxena, Matthew S Yong, Silvana F Marasco, David C McGiffin, Anne Shipp, Robert G Weintraub, Yves d'Udekem, Christian P Brizard, Igor E Konstantinov
Owing to improved surgical results, there is a growing population of patients with repaired congenital heart disease (CHD) requiring heart transplantation. The objective of the study was to review our experience in these patients. A retrospective review of the outcomes of heart transplantation in patients with CHD (n = 77) between 1988 and 2014 was performed. Outcomes of early (1988-1999) and late (2000-2014) eras were compared. In results, the mean age was 18 ± 14 years (range: 16 days-58 years). Seventy (91%) patients underwent a mean of 2...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043445/a-decade-of-experience-with-continuous-flow-left-ventricular-assist-devices
#9
Ranjit John, Christopher T Holley, Peter Eckman, Samit S Roy, Rebecca Cogswell, Laura Harvey, Sara Shumway, Kenneth Liao
The use of continuous-flow left ventricular assist devices (CF-LVADs) has revolutionized the landscape of mechanical circulatory support for patients with heart failure. Clinical trials are already testing the next generation of CF-LVADs. In this study, our objective was to review our long-term experience with the current generation of CF-LVADs, specifically, the HeartMate (HM) II (Thoratec Corp, Pleasanton, CA). In this single-center retrospective analysis, we evaluated the records of 278 consecutive patients who underwent a total of 302 HM II placements from June 2005 through June 2014...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28034580/canadian-cardiovascular-society-canadian-heart-rhythm-society-2016-implantable-cardioverter-defibrillator-guidelines
#10
Matthew Bennett, Ratika Parkash, Pablo Nery, Mario Sénéchal, Blandine Mondesert, David Birnie, Laurence D Sterns, Claus Rinne, Derek Exner, François Philippon, Debra Campbell, Jafna Cox, Paul Dorian, Vidal Essebag, Andrew Krahn, Jaimie Manlucu, Franck Molin, Michael Slawnych, Mario Talajic
Sudden cardiac death is a major public health issue in Canada. However, despite the overwhelming evidence to support the use of implantable cardioverter defibrillators (ICDs) in the prevention of cardiac death there remains significant variability in implantation rates across Canada. Since the most recent Canadian Cardiovascular Society position statement on ICD use in Canada in 2005, there has been a plethora of new scientific information to assist physicians in their discussions with patients considered for ICD implantation to prevent sudden cardiac death due to ventricular arrhythmias...
October 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28029575/use-of-sirolimus-in-pediatric-heart-transplant-patients-a-multi-institutional-study-from-the-pediatric-heart-transplant-study-group
#11
Joseph W Rossano, John L Jefferies, Elfriede Pahl, David C Naftel, Elizabeth Pruitt, Kathy Lupton, William J Dreyer, Richard Chinnock, Gerard Boyle, William T Mahle
BACKGROUND: Proliferation signal inhibitors, such as sirolimus, are increasingly used in solid-organ transplantation. However, limited data exist on sirolimus-treated pediatric patients. We aimed to describe sirolimus use in pediatric heart transplant patients and test the hypothesis that sirolimus use is associated with improved outcomes. METHODS: A retrospective review and propensity-matched analysis of the Pediatric Heart Transplant Study database was performed on patients undergoing primary heart transplantation from 2004 to 2013 with at least 1 year of follow-up comparing patients treated vs not treated with sirolimus at 1 year after transplant...
October 4, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28011759/-end-stage-heart-failure-therapy-potential-lessons-from-congenital-heart-disease-from-pulmonary-artery-banding-and-interatrial-communication-to-parallel-circulation
#12
REVIEW
Dietmar Schranz, Hakan Akintuerk, Norbert F Voelkel
The final therapy of 'end-stage heart failure' is orthotopic heart, lung or heart-lung transplantation. However, these options are not available for many patients worldwide. Therefore, novel therapeutical strategies are needed. Based on pathophysiological insights regarding (1) the long-term impact of an obstructive pulmonary outflow tract in neonates with congenitally corrected transposition of the great arteries, (2) the importance of a restrictive versus a non-restrictive atrial septum in neonates born with a borderline left ventricle and (3) the significance of both, a patent foramen ovale and/or open ductus arteriosus for survival of newborns with persistent pulmonary hypertension, the current review introduces some therapeutical strategies that may be applicable to selected patients with heart failure...
December 23, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28009757/frequency-and-outcomes-of-patients-with-increased-mean-pulmonary-artery-pressure-at-the-time-of-liver-transplantation
#13
Erin S DeMartino, Rodrigo Cartin-Ceba, James Y Findlay, Julie K Heimbach, Michael J Krowka
BACKGROUND: Pulmonary hypertension (PH) exists when mean pulmonary artery pressure (mPAP) is 25 mm Hg or greater. mPAP of 35 mm Hg or greater, with increased pulmonary vascular resistance from portopulmonary hypertension, has been associated with increased post-liver transplant (LT) mortality. However, mPAP of 35 mm Hg or greater can also occur in the setting of normal pulmonary vascular resistance from a high flow state and/or increased pulmonary venous volume. We describe the frequency of patients with mPAP of 35 mm Hg or greater at LT and correlate their clinical outcomes with hemodynamic characteristics...
January 2017: Transplantation
https://www.readbyqxmd.com/read/28009713/outcomes-and-trends-of-ventricular-assist-device-selection-in-children-with-end-stage-heart-failure
#14
Jacob R Miller, Timothy S Lancaster, Deirdre J Epstein, Nicholas C DuPont, Kathleen E Simpson, Chesney Castleberry, Charles E Canter, Pirooz Eghtesady, Umar S Boston
We aimed to examine trends in VAD selection, continuous-flow devices (CFD) versus pulsatile (PFD), and their associated outcomes in children eligible for both device types. To accomplish this, the United Network for Organ Sharing database was reviewed for pediatric patients listed for heart transplant (HT) from January of 2007 through June of 2014. Patients were included if a durable VAD was present at wait listing or when removed from the waiting list, and who met size eligibility for a CFD (BSA > 1.0 m2)...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28007062/rescuing-the-late-failing-fontan-focus-on-surgical-treatment-of-dysrhythmias
#15
REVIEW
Carl L Backer
Patients with a failing Fontan frequently have dysrhythmias. This review will focus on the treatment of those dysrhythmias based on the 140 patients who have had a Fontan conversion with arrhythmia surgery at Ann & Robert H. Lurie Children's Hospital of Chicago (Chicago, IL). Important technical points to be emphasized are the following:• Atrial fibrillation is extremely common in patients with a failing Fontan and strong consideration should be given to a Cox-maze III during any Fontan conversion• Sinus node dysfunction is common post-conversion and all patients should receive a dual-chamber epicardial pacemaker• Careful preoperative imaging with either computed tomographic or magnetic resonance imaging is needed to predict re-entry problems at the time of repeat sternotomy• If the patient has protein-losing enteropathy, ascites, or a right or indeterminate ventricular morphology, strong consideration should be given to heart transplantation rather than a Fontan conversion and arrhythmia surgery...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/28003123/chronic-norovirus-infection-among-solid-organ-recipients-in-a-tertiary-care-hospital-the-netherlands-2006-2014
#16
J van Beek, A A van der Eijk, P L A Fraaij, K Caliskan, K Cransberg, M Dalinghaus, R A S Hoek, H J Metselaar, J Roodnat, H Vennema, M P G Koopmans
OBJECTIVES: Since recent years, it is known that immunocompromised patients can suffer of prolonged norovirus symptoms and viral shedding up to multiple years. Little is known about the prevalence of chronic norovirus infection among solid organ transplant (SOT) recipients. In this study 2182 SOT recipients were retrospectively tested for chronic norovirus infection. METHODS: The first and last norovirus positive faecal sample of SOT recipients was sequenced to distinguish between persisting and re-infection...
December 18, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28000002/stress-perfusion-magnetic-resonance-imaging-to-detect-coronary-artery-lesions-in-children
#17
Chodchanok Vijarnsorn, Michelle Noga, Daryl Schantz, Dion Pepelassis, Edythe B Tham
BACKGROUND: Stress perfusion cardiovascular magnetic resonance (CMR) is used widely in adult ischemic heart disease, but data in children is limited. We sought to evaluate feasibility, accuracy and prognostic value of stress CMR in children with suspected coronary artery disease (CAD). METHODS: Stress CMR was reviewed from two pediatric centers over 5 years using a standard pharmacologic protocol. Wall motion abnormalities, perfusion deficits and late enhancement were correlated with coronary angiogram (CAG) when available, and clinical status at 1 year follow-up for major adverse cardiovascular events (MACE; coronary revascularization, non-fatal myocardial infarction and death due to CAD) was recorded...
December 20, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27999550/the-use-of-berlin-heart-excor-vad-in-children-less-than-10-kg-a-single-center-experience
#18
Arianna Di Molfetta, Fabrizio Gandolfo, Sergio Filippelli, Gianluigi Perri, Luca Di Chiara, Roberta Iacobelli, Rachele Adorisio, Isabella Favia, Alessandra Rizza, Giuseppina Testa, Matteo Di Nardo, Antonio Amodeo
Objective: Despite the improvement in ventricular assist device (VAD) therapy in adults and in adolescents, in infant population only Berlin Heart EXCOR (BHE) is licensed as long term VAD to bridge children to Heart Transplantation (HTx). Particularly demanding in terms of morbidity and mortality are smallest patients namely the ones implanted in the first year of life or with a lower body surface area. This work aims at retrospective reviewing a single center experience in using BHE in children with a body weight under 10 kg...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27989869/the-physiology-of-continuous-flow-left-ventricular-assist-devices
#19
REVIEW
Hoong Sern Lim, Neil Howell, Aaron Ranasinghe
The use of left ventricular assist devices (LVADs) has increased significantly over the last few years, in part because heart transplant activity has plateaued, but also the improving clinical outcomes with contemporary continuous flow LVAD. As such, there is now a growing population of patients with continuous flow LVADs. Management of these patients is complicated by the altered circulatory physiology, as continuous flow LVADs provide a parallel circulation from the heart to the aorta, which interacts with the native left heart (systemic) circulation with consequent effects on the right heart circulation...
October 28, 2016: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27988989/single-center-outcomes-of-combined-heart-and-liver-transplantation-in-the-failing-fontan
#20
B A D'Souza, S Fuller, L P Gleason, N Hornsby, J Wald, K Krok, A Shaked, L R Goldberg, A Pochettino, K M Olthoff, Y Y Kim
Long-term outcomes of the Fontan operation include Fontan failure and liver disease. Combined heart-liver transplantation (CHLT) is an option for select patients although limited data exist on this strategy. A retrospective review of Fontan patients 18 years or older referred for cardiac transplant evaluation between 2000 and 2013 at the Hospital of the University of Pennsylvania was performed. All patients were considered for potential CHLT. Clinical variables such as demographics, perioperative factors, and short-term outcomes were reviewed...
December 17, 2016: Clinical Transplantation
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