Impella RP as a bridge to cardiac transplant for refractory late right ventricular failure in setting of left ventricular assist device

We report the first successful case of extended Impella RP use as a safe and effective bri dge to orthotopic heart transplant in an LVAD patient with refractory, haemodynamically significant late RV failure. The Impella RP provided support for 37 days. Haemodynamically intolerant arrhythmia precluded use of inotropic support. No adverse complications related to percutaneous Impella RP su pport were seen. We also review potential considerations for mechanical circulatory support strategies in this setting: central RV assist device cannulation requires sternotomy incision that can impact subsequent cardiac surgeries, while percutaneous Protek Duo insertion requires adequate vessel siz e and patency. With an LVADin situ, veno ‐arterial extracorporeal membrane oxygenation was not considered for isolated RV support in this case. The patient is currently over 6 months post‐orthotopic heart transplant.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research

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ConclusionsOur findings show the importance of biventricular assessment to detect the severity of this cardiomyopathy and to plan for early clinical intervention. In addition, this study shows that even patients with normal LV function and negative late gadolinium enhancement had MACE. ML is a promising tool for analysing a large set of parameters to stratify and predict prognosis in LVNC patients.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
AbstractAimsRight ventricular hypertrophy (RVH) is a common finding in Anderson –Fabry disease (AFD), but the prognostic role of right ventricular (RV) involvement has never been assessed. The aim of our study was to evaluate the prognostic significance of RVH and RV systolic function in AFD.Methods and resultsForty ‐five AFD patients (56% male patients) with extensive baseline evaluation, including assessment of RVH and RV systolic function, were followed‐up for an average of 51.2 ± 11.4 months. RV systolic function was assessed by standard and tissue Doppler echocardiography. Cardiovascula...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
Abstract Arrhythmogenic right ventricular cardiomyopathy (ARVC) appears in most patients to be an inherited disease characterized by fibrofatty replacement of myocytes extending from epicardium to endocardium in the right ventricle. The disease process results in life-threatening ventricular arrhythmias and ventricular dysfunction. In the absence of a gold standard diagnostic test and despite the progress in imaging techniques, ARVC is often misdiagnosed and earlier detection of the disease is challenging. Pre-procedural identification and localization of the substrate can be determined from the analysis of surfac...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
The use of left ventricular assist devices (LVADs), whether for destination therapy or bridge to transplantation, has gained increasing validation in recent years in patients with advanced heart failure. Arrhythmias can be the most challenging variables in the management of such patients but the main attention has always been focused on ventricular arrhythmias given the detrimental impact on mortality. Nevertheless, atrial fibrillation (AF) is the most common rhythm disorder associated with advanced heart failure and may therefore characterize the LVADs ’ pre- and postimplantation periods. Indeed, the consequences of...
Source: Pulse - Category: Cardiology Source Type: research
In conclusion, our study demonstrated that Nrf2 deficiency promoted the increasing trend of autophagy during aging in skeletal muscle. Nrf2 deficiency and increasing age may cause excessive autophagy in skeletal muscle, which can be a potential mechanism for the development of sarcopenia. To What Degree is Chondrocyte Hypertrophy in Osteoarthritis Due to Cellular Senescence? Senescent cells are large. They do not replicate, that function is disabled, but it is as if they go ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Omecamtiv mecarbil (OM) is a first in class selective myosin activator, developed to increase contractile force without altering intracellular calcium concentrations in patients with advanced heart failure (AHF). We sought to investigate the effect of OM on contractility, arrhythmia genesis and interaction with Beta 1-adrenoceptor (B1AR) inotropes directly on explanted human failing heart.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (895) Source Type: research
Amiodarone is a commonly used anti-arrhythmic medication for atrial and ventricular arrhythmias in end-stage heart failure. Due to heavy iodine content, amiodarone is implicated in a variety of thyroid disorders, which could lead to adverse outcomes in cardiac transplant (CT) patients. Data on the development of post-CT lymphocytic thyroiditis (LT) in patients with pre-CT amiodarone use is limited. We aimed to study the development of amiodarone-induced LT in CT patients in a tertiary care transplant center in the United States.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (394) Source Type: research
We describe the anesthetic management for this innovative technique addressing technique-specific issues such as arrhythmia management, hemostasis, right heart failure and postoperative pain control.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (852) Source Type: research
Authors: Chiba Y, Fukushima A, Nakao M, Kobayashi Y, Ishigaki T, Tenma T, Kamiya K, Shingu Y, Ooka T, Matsui Y, Anzai T Abstract A 23-year-old man had progressive muscle weakness and Emery-Dreifuss muscular dystrophy (EDMD) due to a LMNA (lamin A/C) mutation. Congestive heart failure diagnosed at 19 years of age. Maximal drug treatment/cardiac resynchronization failed to improve the cardiac function. He was therefore hospitalized due to heart failure. Despite extracorporeal membrane oxygenation, he developed severe right heart dysfunction and died (multiple organ failure). A cardiac lesion's presence determines the...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Several cancer treatments cause cardiotoxicity that can lead to heart failure, coronary artery disease, arrhythmia, and pericardial disease. In this review, representative cases of heart failure following cardiotoxicity caused by trastuzumab, anthracycline, and hematopoietic stem cell transplantation are described with case notes. Additionally, other important points regarding cardiotoxicity related to heart failure are reported. During and after potentially cardiotoxic therapy, periodic cardiac examinations are recommended to detect any cardiovascular disorders; these are ameliorated if appropriately diagnosed at an earli...
Source: Heart Failure Clinics - Category: Cardiology Authors: Source Type: research
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