Heart transplantation in patients with ventricular assist devices: Impacts of the implantation technique and support duration

AbstractBackgroundOrthotopic heart transplantation (HTx) is the gold standard treatment for patients with terminal heart failure. As donor organs are limited, patients are often on ventricular assist device (VAD) support before receiving HTx. We aimed to compare the outcome after HTx in patients with and without preoperative VADs as well as in patients who underwent different VAD implantation techniques.MethodsA total of 126 patients underwent HTx at our department between 2010 and 2019 and were retrospectively analyzed. While 47 patients underwent primary transplantation (No VAD), 79 were on VAD support. The preoperative and intraoperative parameters were comparable between the two groups.ResultsVAD support significantly increased the HTx operation time (
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research

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Robert Chelsea turned down the first face he was offered. It was a fine face, one that could have taken him off the transplant waiting list after just a couple months. But Chelsea—severely disfigured after a catastrophic car accident five years earlier—was in no hurry. He’d gotten used to tilting his head back so food and water wouldn’t fall out of his nearly lipless mouth. He knew how to respond compassionately to children who stared in shock and fear. The face, offered in May 2018, had belonged to a man with skin that was much fairer than what remained of Chelsea’s—so light that Chelse...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Healthcare Source Type: news
In patients supported by left ventricular assist devices (LVADs), half of all non-gastrointestinal bleeding (GIB)-related anemias are related to iron-deficiency (IDA). The clinical benefits of intravenous (IV) iron replacement in heart failure are well described, but there is a paucity of data regarding the treatment of IDA in LVAD patients. This pilot study aimed to determine the impact of IV ferric carboxymaltose (FCM) on anemia, blood transfusion requirements, readmissions,&functional capacity in the LVAD population.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: 253 Source Type: research
CONCLUSION: These results show the necessity of carefully considering changes in blood concentrations that occur in immunosuppressive agents due to PPH, including the pharmacokinetics of the particular drug. However, proper timing of the PPH relative to drug administration can also minimize immunosuppressant loss.
. PMID: 30220292 [PubMed - as supplied by publisher]
Source: International Journal of Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research
AbstractPurposeEnd-stage renal disease (ESRD) is associated with increased cardiovascular risk factors, electrolyte imbalances, and iron deficiency anemia. These factors may increase the risk of adverse outcomes in patients undergoing panniculectomy. There is a paucity of data regarding outcomes in patients with ESRD undergoing panniculectomy. The purpose of this study is to investigate whether ESRD is associated with increased rate of complications following a panniculectomy.MethodThe Nationwide Inpatient Sample database (2006 –2011) was used to identify patients who underwent a panniculectomy. Among this cohort, pa...
Source: Aesthetic Plastic Surgery - Category: Cosmetic Surgery Source Type: research
Abstract Continuous-flow left ventricular assist devices (CF-LVADs) have significantly improved outcomes for patients with end-stage heart failure when used as a bridge to cardiac transplantation or, more recently, as destination therapy. However, its implantations carries a risk of complications including infection, device malfunction, arrhythmias, right ventricular failure, thromboembolic disease, postoperative and nonsurgical bleeding. A significant number of left ventricular assist devices (LVAD) recipients may experience recurrent gastrointestinal hemorrhage, mainly due to combination of antiplatelet and vita...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Today, I cleaned the laceration above your eye from where he punched you with a closed fist. As I was stitching up the gaping wound with two layers of sutures, I told you that the scar would fade into the line of your eyebrow. I helped you apply your foundation on your neck to cover the bruising from where he strangled you. I monitored you for any swelling of your airway. I wrote down the names of the local battered women’s shelters and hotlines and slipped the paper in your shoe. I offered to call the police for you no fewer than ten times. I told you how I feared the next time you would not be discharged home. Toda...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Emergency Source Type: blogs
Medtronic (NYSE:MDT) said today it won CE Mark approval in the European Union for a less-invasive implant procedure for the HVAD system left ventricular assist device it acquired along with HeartWare in August. The new implantation procedure uses a smaller incision than the previously cleared procedure, Fridley, Minn.-based Medtronic said, potentially lessening bleeding and related blood transfusions. The newly cleared procedure could potentially reduce the development of right heart failure and could lead to shorter hospital stays, along with allowing for the area around the heart to remain largely intact to potentia...
Source: Mass Device - Category: Medical Equipment Authors: Tags: Cardiac Assist Devices Cardiac Implants Cardiovascular Regulatory/Compliance Surgical HeartWare International Inc. Medtronic Source Type: news
We report the successful off-label implantation of a self-expandable transcatheter valve in a Jehovah's Witness with prior replacement of the ascending aorta for Type A dissection, residual severe aortic regurgitation and refractory heart failure.
Source: Interactive CardioVascular and Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: History, Pericardium, Transplantation - heart, Basic research vascular, Vascular malformations Adult Cardiac Source Type: research
Conclusion: We conclude that HD treatment is possible despite TAH and should be considered in patients with both end stage renal and HF.Blood Purif 2016;42:301-303
Source: Blood Purification - Category: Hematology Source Type: research
CONCLUSIONS The 30-day outcomes following implantation of the HeartMate 3 demonstrates excellent survival with low adverse event rates. The LVAD performed as intended with no haemolysis or device failure. CLINICALTRIALS.GOV IDENTIFIER NCT02170363. HeartMate 3™ CE Mark Clinical Investigation Plan (HM3 CE Mark).
Source: European Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Minimally invasive surgery, Myocardial protection, Peripheral vascular TRANSPLANTATION AND MECHANICAL CIRCULATORY SUPPORT Source Type: research
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