The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
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J. Heart Lung Transplant. · Nov 2006
Hemodilution modulates the time of onset and rate of fibrinolysis in human and rabbit plasma.
Fibrinolysis has a critical role in the development of bleeding after insertion of a ventricular assist device (VAD). However, chronically, VAD-mediated fibrinolysis may also diminish thromboembolic events. Management of VADs involves fluid administration. It was hypothesized that the fluid administered could modulate fibrinolysis. ⋯ Compared with crystalloid or albumin, HES solutions enhance fibrinolysis by decreasing clot strength and decreasing the time of onset of fibrinolysis. Further studies are warranted to determine whether the fluid administered to patients with VADs can impact hemorrhagic and thrombotic morbidity.
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J. Heart Lung Transplant. · Nov 2006
Clinical TrialEfficacy of sildenafil as a rescue therapy for patients with severe pulmonary arterial hypertension and given long-term treatment with prostanoids: 2-year experience.
Both prostanoids and sildenafil are effective treatments for severe pulmonary arterial hypertension (PAH). The combined use of these drugs to maximize the clinical benefit is an emerging treatment option. This study describes a 2-year experience with adjunct sildenafil as a rescue therapy for patients with severe PAH treated long term with prostanoids and who showed clinical deterioration or onset of heart failure. ⋯ Adjunct sildenafil to long-term prostacyclin therapy in patients with severe PAH provided sustained clinical stabilization and an improved clinical situation, exercise capacity and echocardiographic parameters of right ventricular function. The beneficial effects were strong and lasted >24 months.
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J. Heart Lung Transplant. · Nov 2006
Case ReportsSalvage right pneumonectomy in a patient with bronchial-pulmonary artery fistula after bilateral sequential lung transplantation.
Bronchovascular fistula is a rare but fatal complication in lung transplant recipients. We report the successful salvage of a right pneumonectomy performed in a patient with a fistula between the right main bronchus and the pulmonary artery after ulcerative bronchitis caused by Aspergillus fumigatus.