Pumpless Paracorporeal Assist Device Helps Infants With Severe Respiratory Failure Survive Until Lung Transplantation

Adults with end-stage respiratory failure and pulmonary hypertension requiring ECMO (extracorporeal membrane oxygenation) have been "bridged" toward lung transplantation with novel lung assist devices such as the Novalung. This and related devices work based on pumpless application of oxygenators. A presentation by David M. Hoganson, MD, and colleagues from Washington University School of Medicine in St. Louis at the Congenital Heart Disease Session of the 93rd AATS Annual Meeting described the first time application of this technology to newborns and small children...
Source: Health News from Medical News Today - Category: Consumer Health News Tags: Transplants / Organ Donations Source Type: news

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Right ventricular failure (RVF) is still associated with an increased mortality in patients with pulmonary hypertension (PH) or congenital heart disease. Transition from right ventricular dysfunction to RVF is not predictable and has not been well understood so far. Several studies in rodents and in piglets showed that impairment of capillary density (CD) in the right ventricle (RV) is associated with right ventricular failure (1, 2). Some evidence suggested that the RV of patients with Eisenmenger Syndrome (ES) has remarkable adaptive capacities to high pulmonary pressures (3), leading to a longer survival in these patien...
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Research Correspondence Source Type: research
Despite the numerous innovations in all diagnostic and treatment aspects of congenital heart disease, the management of pulmonary vein stenosis (PVS), primary or postoperative, continues to be perplexing and 1-2 year survival of patients with progressive PVS seems to have stubbornly plateaued at a low range of 50-60%.1-4 Various medical, percutaneous and surgical treatment modalities for PVS have been described. Nonetheless, all those options continue to be associated with inferior outcomes due to residual lesions, recurrent stenosis secondary to disease progression in the same or other pulmonary veins, development of pulm...
Source: Seminars in Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Congenital – Editorial Commentary Source Type: research
We present a case of living-donor lung transplantation for a 12-year-old girl with pulmonary hypertension after surgical repair of transposition of great arteries. Despite repairing the transposition of great arteries, her growth was severely restricted because of progressive pulmonary hypertension; thus, lung transplantation was discussed. Standard bilateral lobar transplantation seemed unfeasible due to oversized grafts, so we performed a single lobar transplantation. Unexpectedly, she developed complications and died 3 months postoperatively despite another emergent lobar transplantation. We discussed the challenges and...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Right ventricular (RV) is a key driver of outcome in heart failure and pulmonary vascular disorders. Although the RV fails in response to an increased afterload, it has been shown to be affected in patients with left heart diseases in the absence of pulmonary hypertension (PH). Therefore, it is recommended to consider the RV and the pulmonary artery (PA) as a single unit, defined physiologically by RV-PA coupling. The aim of this study is to assess whether non-invasive RV-PA coupling may predict outcome in PAH and in LHD.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Pulmonary hypertension (PH) due to left heart disease (LHD) is a marker of poor prognosis in patients with advanced heart failure.Fixed PH with elevated pulmonary vascular resistance (PVR) is a major contraindication to heart transplantation.Continuous-flow left ventricular assist devices (cf-LVADs) can reduce pulmonary pressures in patients with advanced heart failure with reduced ejection fraction (HFrEF).The purpose of the study was to assess long-term effect of cf-LVAD on type II PH in HFrEF,and to evaluate the association of clinical and haemodynamic variables with PH persistence after LVAD implantation.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
The objective of this study is to assess the ability of cardiopulmonary exercise testing (CPX) variables to detect Cpc-PH.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Differentiating pre-capillary or pulmonary arterial hypertension (PAH) from pulmonary hypertension (PH) related to left-sided heart disease (PH-LHD) can be challenging. Pulmonary arterial wedge pressure (PAWP) measured at right heart catheterization is required for classifying PH. However, a normal PAWP is a poor predictor for absence of left heart disease. Therefore, there has been an interest in using fluid challenge to unmask PH-LHD. The purpose of our study is to evaluate the impact of fluid challenge in the classification and management of a real-world population.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
Clinicians in pulmonary medicine frequently confront the challenge of screening, diagnosis, and management of pulmonary hypertension (PH) in sarcoidosis patients who present with unexplained dyspnea. Sarcoidosis-associated pulmonary hypertension (SAPH) is most prevalent in patients with pulmonary fibrosis, although it can be independent of airflow obstruction or restriction. SAPH is independently associated with significantly increased mortality and decreased functional capacity, outcomes that can be mitigated by early detection and focused treatment. In this review, we discuss the pathophysiology of SAPH, which may resemb...
Source: Clinical Pulmonary Medicine - Category: Respiratory Medicine Tags: Interstitial, Inflammatory and Occupational Lung Disease Source Type: research
 >>>Available Here with Free Look Inside Option Correct answer: 3. Both 1 and 2 In domino heart transplantation, the donor receives heart lung transplantation. The excised heart is transplanted to another recipient so that the donor for recipient of domino heart transplantation is alive, unlike the conventional donor who is brain dead. In one report of 10 cases of domino heart transplantation, one year survival of donor was 60% while that of recipient was 90% [1]. It worthwhile noting that donors had terminal cardio pneumopathy (mostly primary pulmonary hypertension, one case of Eisenmenger syndrome and ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Pulmonary hypertension (PH) refers to increased pressure in the pulmonary circulation. It develops when pulmonary vessels become constricted and/or obstructed, which can occur in a wide variety of conditions. The increase in pressure is measured by right catheterization, and is defined as a mean pulmonary arterial pressure ≥ 25 mm Hg at rest. PH leads to right ventricular hypertrophy and enlargement as the ventricle pumps against increased resistance. Right-sided heart failure (cor pulmonale) can eventually develop. Signs and symptoms of PH include dyspnea on exertion, fatigue, substernal chest pain, syncope, hepatomega...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Pulmonology Source Type: blogs
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