Combined Heart Transplantation and Thoracic Endovascular Aortic Repair for Heart Failure Secondary to Tricuspid Atresia Palliated with Potts Shunt

2013 ◽  
Vol 8 (3) ◽  
pp. 242-244 ◽  
Author(s):  
Bobby Yanagawa ◽  
Lucas Collazo ◽  
Nelson Burton ◽  
Niv Ad ◽  
Alan M. Speir
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Heart Function ◽  
Normal Activity ◽  
Tricuspid Atresia ◽  
Orthotopic Heart Transplantation ◽  
Endovascular Stent ◽  
Endovascular Stent Graft ◽  
Progressive Heart Failure

A 57-year-old-man with known tricuspid atresia previously palliated with a Potts shunt had developed progressive heart failure refractory to medical management. He underwent a combined thoracic endovascular stent graft procedure to eliminate the Potts shunt and orthotopic heart transplantation. At 3-month follow-up, right-sided heart function and pulmonary artery pressures as well as pulmonary vascular resistance had normalized, and at 7 months, the patient had returned to normal activity. The surgical management and its principles as well as postoperative follow-up are described.

Rapidly progressive heart failure requiring transplantation in muscular dystrophy: a need for frequent screening

2017 ◽  
Vol 27 (9) ◽  
pp. 1836-1840 ◽  
Author(s):  
Justin M. Pick ◽  
Zachary D. Ellis ◽  
Juan C. Alejos ◽  
Anthony C. Chang
Keyword(s):  
Heart Failure ◽  
Muscular Dystrophy ◽  
Heart Transplantation ◽  
Skeletal Muscles ◽  
Heart Function ◽  
Congenital Muscular Dystrophy ◽  
Musculoskeletal Symptoms ◽  
Skeletal Myopathy ◽  
Progressive Heart Failure ◽  
Cardiac Muscles

AbstractFukuyama congenital muscular dystrophy weakens both skeletal and cardiac muscles, but the rate of cardiomyopathic progression can accelerate faster than that of skeletal muscles. A 14-year-old boy with Fukuyama congenital muscular dystrophy presented with mild skeletal myopathy but severe cardiomyopathy requiring heart transplantation within 1 year of declining heart function. These patients need frequent screening regardless of musculoskeletal symptoms.

scholarly journals The Man with 2 Hearts: 25 Years from Heterotopic to Orthotopic Heart Transplantation

2019 ◽  
Vol 46 (3) ◽  
pp. 199-202
Author(s):  
Elizabeth L. Godfrey ◽  
Michael L. Kueht ◽  
Abbas Rana ◽  
O.H. Frazier
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Heart Function ◽  
Human Leukocyte ◽  
Total Artificial Heart ◽  
Circulatory Support ◽  
Orthotopic Heart Transplantation ◽  
Orthotopic Transplantation ◽  
Heterotopic Heart Transplantation ◽  
Coronary Artery Stent

Substantial technological advances in mechanical circulatory support have caused a shift in the management of end-stage heart failure. From the 1970s through the 1990s, heterotopic heart transplantation was routinely performed in patients in whom orthotopic transplantation was likely to fail. Heterotopic heart transplantation is now performed less often because modern mechanical circulatory assist devices are routinely used as bridges to orthotopic transplantation; regardless, the operation has helped numerous patients who would not otherwise have received adequate allografts. We describe the case of a man with idiopathic nonischemic cardiomyopathy who, at age 17, was given an ABO- and size-matched heterotopic allograft that was a complete human leukocyte antigen mismatch. The graft functioned normally for 20 years until the patient had a myocardial infarction that necessitated placement of a coronary artery stent. Subsequent treatments involved many interventions, including insertion of an intra-aortic balloon pump, medical therapy for heart failure, implantation of a total artificial heart, and, ultimately, orthotopic transplantation. To our knowledge, our patient is the longest surviving recipient of a heterotopic heart transplant, with a remarkable 25-year graft survival despite poor histocompatibility and an almost complete lack of native heart function. The strategies used for his treatment make him a living case study that can add valuable information to the history of cardiac support.

Coronary sinus catalase and ceruloplasmin levels predict all-cause mortality in patients with end-stage heart failure awaiting heart transplantation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
W Szczurek ◽  
M Gasior ◽  
M Skrzypek ◽  
G Kubiak ◽  
A Kuczaj ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Coronary Sinus ◽  
Public Institution ◽  
Funding Source ◽  
Organ Shortage ◽  
Number Of Patients ◽  
End Stage ◽  
Medical University

Abstract   Background, As a consequence of the worldwide increase in life expectancy and due to significant progress in the pharmacological and interventional treatment of heart failure (HF), the proportion of patients that reach an advanced phase of disease is steadily growing. Hence, more and more numerous group of patients is qualified to the heart transplantation (HT), whereas the number of potential heart donors has remained invariable since years. It contributes to deepening in disproportion between the demand for organs which can possibly be transplanted and number of patients awaiting on the HT list. Therefore, accurate identification of patients who are most likely to benefit from HT is imperative due to an organ shortage and perioperative complications. Purpose The aim of this study was to identify the factors associated with reduced survival during a 1.5-year follow-up in patients with end-stage HF awating HT. Method We propectively analysed 85 adult patients with end-stage HF, who were accepted for HT at our institution between 2015 and 2016. During right heart catheterization, 10 ml of coronary sinus blood was additionally collected to determine the panel of oxidative stress markers. Oxidative-antioxidant balance markers included glutathione reductase (GR), glutathione peroxidase (GPx), glutathione transferase (GST), superoxide dismutase (SOD) and its mitochondrial isoenzyme (MnSOD) and cytoplasmic (Cu/ZnSOD), catalase (CAT), malondialdehyde (MDA), hydroperoxides lipid (LPH), lipofuscin (LPS), sulfhydryl groups (SH-), ceruloplasmin (CR). The study protocol was approved by the ethics committee of the Medical University of Silesia in Katowice. The endpoint of the study was mortality from any cause during a 1.5 years follow-up. Results The median age of the patients was 53.0 (43.0–56.0) years and 90.6% of them were male. All included patients were treated optimally in accordance with the guidelines of the European Society of Cardiology. Mortality rate during the follow-up period was 40%. Multivariate logistic regression analysis showed that ceruloplasmin (odds ratio [OR] = 0.745 [0.565–0.981], p=0.0363), catalase (OR = 0.950 [0.915–0.98], p=0.0076), as well as high creatinine levels (OR = 1.071 [1.002–1.144], p=0.0422) were risk factors for death during 1.5 year follow-up. Conclusions Coronary sinus lower ceruloplasmin and catalase levels, as well as higher creatinine level are independently associated with death during 1.5 year follow-up. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Medical University of SIlesia, Katowice, POland

scholarly journals Neurologic complications after heart transplantation

2002 ◽  
Vol 60 (2A) ◽  
pp. 192-197 ◽  
Author(s):  
Suzana M.F. Malheiros ◽  
Dirceu R. Almeida ◽  
Ayrton R. Massaro ◽  
Adauto Castelo ◽  
Rosiane V.Z. Diniz ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Prospective Observational Study ◽  
Cord Compression ◽  
Orthotopic Heart Transplantation ◽  
Cns Infection ◽  
Neurologic Complications ◽  
Neurologic Disability ◽  
End Stage ◽  
Neurologic Event

OBJECTIVE: Neurologic complications are known as important cause of morbidity and mortality in orthotopic heart transplantation. Our aim was to identify the frequency and outcome of neurologic complications after heart transplantation in a prospective observational study. METHOD: From September 93 to September 99, as part of our routine heart transplantation protocol all patients with end-stage cardiac failure were evaluated by the same neurologist before and at the time of any neurologic event (symptom or complaint) after transplantation. RESULTS: Out of 120 candidates evaluated, 62 were successfully transplanted (53 male; median age 45.5 years, median follow-up 26.8 months). Fifteen patients (24%) had ischemic, 22 (35%) idiopathic, 24 (39%) Chagas' disease and 1 (2%) had congenital cardiomyopathy. Neurologic complications occurred in 19 patients (31%): tremor, severe headache, transient encephalopathy and seizures related to drug toxicity or metabolic changes in 13; peripheral neuropathy in 4; and spinal cord compression in two (metastatic prostate cancer and epidural abscess). No symptomatic postoperative stroke was observed. CONCLUSIONS: Although frequent, neurologic complications were seldom related to persistent neurologic disability or death. Most of the complications resulted from immunosuppression, however, CNS infection was rare. The absence of symptomatic stroke in our series may be related to the lower frequency of ischemic cardiomyopathy.

scholarly journals Endovascular repair of an aorto-iliac aneurysm succeeded by kidney transplantation

2010 ◽  
Vol 9 (3) ◽  
pp. 164-167
Author(s):  
Marcelo Bellini Dalio ◽  
Matheus Bredarioli ◽  
Edwaldo Edner Joviliano ◽  
Jesualdo Cherri ◽  
Haylton Jorge Suaid ◽  
...  
Keyword(s):  
Renal Failure ◽  
Kidney Transplantation ◽  
Endovascular Repair ◽  
External Iliac Artery ◽  
Iliac Aneurysm ◽  
Endovascular Stent ◽  
Resonance Imaging ◽  
Endovascular Stent Graft ◽  
End Stage

We present the case of aorto-iliac aneurysm in a patient with chronic renal failure requiring dialysis who were treated with an endovascular stent graft and, later on, submitted to kidney transplantation. A 53-year-old male with renal failure requiring dialysis presented with an asymptomatic abdominal aorto-iliac aneurysm measuring 5.0cm of diameter. He was treated with endovascular repair technique, being used an endoprosthesis Excluder®. After four months, he was successfully submitted to kidney transplantation (dead donor), with anastomosis of the graft renal artery in the external iliac artery distal to the endoprosthesis. The magnetic resonance imaging, carried out 30 days after the procedure, showed a good positioning of the endoprosthesis and adequate perfusion of the renal graft. In the follow-up, the patient presented improvement of nitrogenous waste, good positioning of the endoprosthesis without migration or endoleak. The endovascular repair of aorto-iliac aneurysm in a patient with end-stage renal failure under hemodialysis treatment showed to be feasible, safe and efficient, as it did not prevent the success of the posterior kidney transplantation.

Total 12-Lead QRS Voltage in Patients Having Orthotopic Heart Transplantation for Heart Failure Caused by Adriamycin-Induced Cardiomyopathy

Cardiology ◽  
2018 ◽  
Vol 141 (3) ◽  
pp. 172-175 ◽  
Author(s):  
William C. Roberts ◽  
Sarah Haque ◽  
Shelley A. Hall
Keyword(s):  
Heart Failure ◽  
Heart Transplantation ◽  
Cardiac Amyloidosis ◽  
Cardiac Sarcoidosis ◽  
Medical Center ◽  
Severe Heart Failure ◽  
Orthotopic Heart Transplantation ◽  
S Wave ◽  
Baylor University ◽  
Before And After

Objective: Although several studies have described the effects of adriamycin on the heart, electrocardiographic total 12-lead QRS voltage (distance in millimeters from the peak of the R wave to the nadir of either the Q or S wave, whichever was deeper, with 10 mm [1 mV] being standard) both before and after orthotopic heart transplantation (OHT) has not been reported. This study describes the total 12-lead QRS voltage in 8 patients studied at Baylor University Medical Center at Dallas, from 1994 to June 2018, who underwent OHT for severe heart failure caused by anthracycline-induced cardiomyopathy. Method: Prior to OHT, the total 12-lead non-paced QRS voltages ranged from 86 to 189 mm (mean 125 ± 56) and for paced QRS voltages from 82 to 113 mm (mean 97 ± 15). The total 12-lead QRS voltages post-OHT ranged from 100 to 190 mm (mean 130 ± 30). Total 12-lead QRS voltages were lower in patients with a pacemaker than without. Results/Conclusion: These low voltages are like those found in patients with carcinoid syndrome, severe cardiac adiposity, cardiac amyloidosis, and cardiac sarcoidosis.

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