New era of pediatric ventricular assist devices: Let us go to school
Abstract As there is still a shortage of pediatric donor hearts, several techniques have been used to assist pediatric patients to survive until transplantation. VADs provide long‐term support and ability of mobilization for children before a suitable heart becomes available. Several devices such as paracorporeal pumps have been used for this purpose, with acceptable morbidity and mortality rates. However, discharge is not possible, as there is no mobile drive unit for these small‐sized pumps. The possible negative psychosocial impact of long‐term hospitalization, away from home and school, may cause some adjustment problems in the future. In this case series, three pediatric patients that underwent intracorporeal LVAD implantation and returned to school are presented to share clinical experience and also to attract attention to the potential social and psychiatric implications.
Condition: Heart Transplantation Intervention: Device: XVIVO heart preservation devices Sponsor: XVIVO Perfusion Not yet recruiting
I am delighted to be a small part of this USA Today story on ECMO. It includes some compelling patient stories. ECMO is not designed to be a destination, but a bridge to somewhere – recovery, transplantation or an implanted heart device. But when patients are too sick to reach those goals, ECMO can become a "bridge to nowhere," leaving the patient in limbo, possibly even awake and alert, but with no chance of survival outside the intensive care unit. Medical teams and families can be fiercely divided over when to pull the plug.
ConclusionsDespite achieving similar levels of LVEF improvement, patients with systolic heart failure with chronic RVP undergoing upgrade to CRT have inferior long term outcomes compared to patients with native LBBB. Long term outcomes with CRT in patients with chronic RVP, RBBB, and IVCD are similar.This article is protected by copyright. All rights reserved.
ConclusionDiamond –Blackfan anemia is a rare disease that carries significant morbidity and mortality if not diagnosed early and managed appropriately. Limited health resources, patient registries, and specialists as seen in developing countries result in a paucity of knowledge about Diamond–Blackfan anemia in Af rica. This case reminds clinicians about Diamond–Blackfan anemia as a cause for anemia in infants, the limitations in making the diagnosis in under-resourced health care systems, and the need for standardized treatment protocols applicable to resource-limited countries.
The role of inflammation in the development and progression of heart failure has been well described.1,2 Our group has recently described that decreased immune cell function carries an adverse prognostic implications for patients with heart failure referred for cardiac transplantation.3 Right ventricular dysfunction is a marker of poor prognosis in heart failure with preserved and reduced ejection fraction.4,5 We hypothesized that right ventricular failure would be associated with decreased immune cell function.
Abstract We have shown that the effects of transplantation of CD146+ mesenchymal stem cells (MSCs) on myocardial regeneration after myocardial infarction (MI) exceeds the effects of transplantation of MSCs, likely resulting from reduction of aging-associated cellular reactive oxygen species in injured cardiac muscle cells (CMCs). Since the role of macrophages in the MSC-mediated recovery of heart function after MI remains unclear, this question was thus addressed in the current study. We found that transplantation of MSCs did not alter the total number of the macrophages in the injured heart, but induced their pol...
Journal of Cardiac Surgery, EarlyView.
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The objectives of the current study were to evaluate the impact of BTT with LVAD on posttransplant survival, to describe differences in causes of 1-year mortality in medically and mechanically bridged patients, and to evaluate differences in risk factors for 1-year mortality between those with and without LVAD at the time of HT. METHODS: Using the United Network of Organ Sharing (UNOS) database, we identified 5486 adult, single-organ HT recipients transplanted between 2008 and 2015. Patients were propensity matched for likelihood of LVAD at the time of HT. Kaplan-Meier survival estimates were used to assess the impact...
AbstractMucopolysaccharidoses (MPS) are inborn errors of metabolism produced by a deficiency of one of the enzymes involved in the degradation of glycosaminoglycans (GAGs). Although taken separately, each type is rare. As a group, MPS are relatively frequent, with an overall estimated incidence of around 1 in 20,000 –25,000 births. Development of therapeutic options for MPS, including hematopoietic stem cell transplantation (HSCT) and enzyme replacement therapy (ERT), has modified the natural history of many MPS types. In spite of the improvement in some tissues and organs, significant challenges remain unsol ved, in...