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. · Dec 2006
Case ReportsManagement of aortic insufficiency with continuous flow left ventricular assist devices: bioprosthetic valve replacement.
There are several methods for surgical management of aortic insufficiency in patients with end-stage congestive heart failure who are undergoing implantation of a left ventricular assist device (LVAD). To date, little is known about the long-term outcome of bioprosthetic valves for aortic insufficiency in patients with continuous flow LVADs. We report on two patients with bioprosthetic aortic valve replacement for aortic insufficiency at the time of HeartMate II LVAD insertion.
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J. Heart Lung Transplant. · Dec 2006
Attenuation of lung reperfusion injury by modified ventilation and reperfusion techniques.
High ventilation and perfusion pressures after lung transplantation may have deleterious effects. We hypothesized that using combined protective approaches for ventilation and perfusion would be optimal for reducing injury and improving function after ischemia-reperfusion. ⋯ This protective approach of ventilation and perfusion after ischemia may improve lung function after transplantation, a simple method that could easily be applied clinically.
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J. Heart Lung Transplant. · Dec 2006
A quantitative gene expression profile of matrix metalloproteinases (MMPS) and their inhibitors (TIMPS) in the myocardium of patients with deteriorating heart failure requiring left ventricular assist device support.
Mechanisms underlying the rapid deterioration of heart failure patients who subsequently require left ventricular assist device (LVAD) support are poorly understood. Matrix metalloproteinases (MMPs) and the tissue inhibitors of metalloproteinases (TIMPs) play a key role in myocardial remodelling and heart failure. We hypothesized that MMP and TIMP expression would be altered in these patients. ⋯ The data show that high myocardial collagenase (MMP1 and MMP8) expression without compensatory changes in collagen or TIMP expression is a feature of patients requiring LVAD support. This may be linked in part to elevated cytokine expression and suggests collagenase activity may be an important therapeutic target in deteriorating heart failure.