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. · Jan 2006
Case ReportsDouble lung transplantation in a patient with tracheobronchomegaly (Mounier-Kuhn syndrome).
Mounier-Kuhn syndrome is a rare condition characterized by marked dilation of the trachea and main bronchi resulting in bronchiectasis and emphysema. We report a case in which a patient underwent successful double lung transplantation for COPD that was found on pathologic examination of the explanted lungs to be Mounier Kuhn syndrome. To our knowledge this is the first case reporting lung transplantation in this syndrome.
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J. Heart Lung Transplant. · Jan 2006
Prevalence, pathophysiology, and clinical significance of post-heart transplant atrial fibrillation and atrial flutter.
Atrial rhythm disturbances, in particular atrial fibrillation (AF) and flutter (AFL), are common in the denervated transplanted heart. However, there is a relative paucity of data in the prevalence, mechanism of arrhythmia, and long-term significance. ⋯ Development of AF/AFL post-heart transplantation is not uncommon and is associated with decreased long-term survival. Cumulative effects of repeated moderate-to-severe (grade 3 or more) rejections that result in increased cardiac fibrosis are associated with the development of AFL, but not AF. Similarly advanced restrictive diastolic dysfunction caused by fibrosis from repeated moderate-to-severe (grade 3 or more) rejections was predominant in the patients with arrhythmia and was a marker of poor long-term outcome.
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J. Heart Lung Transplant. · Jan 2006
Lung transplantation in patients with chronic obstructive pulmonary disease in a national cohort is without obvious survival benefit.
The objective in lung transplantation is to prolong life, but the survival effect in patients with chronic obstructive pulmonary disease (COPD) or alpha1-anti-trypsin deficiency emphysema is still unresolved. This study assesses the impact of diagnosis, single-lung transplantation (SLT) vs bilateral lung transplantation (BLT) and timing of transplantation on survival in a national cohort. ⋯ In COPD/emphysema, there was no obvious survival benefit from lung transplantation, which questions prolongation of life as the primary motivation for the procedure.
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J. Heart Lung Transplant. · Jan 2006
Pediatric bridge to heart transplantation: application of the Berlin Heart, Medos and Thoratec ventricular assist devices.
Bridge to transplantation (BTT) is an accepted option when a donor heart is not available. Extensive clinical study has been done with BTT in the adult population, but comparatively fewer data are available in the pediatric population with regard to pulsatile devices. ⋯ The Thoratec VAD can be placed in small patients with large hearts that can accommodate the available cannulas. The Berlin Heart and the Medos VAD have a selection of ventricles with small stroke volumes. All 3 systems can be used successfully in the pediatric population as BTT with better survival than with ECMO.
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J. Heart Lung Transplant. · Jan 2006
Prognostic value of the QTc interval after cardiac transplantation.
Although QTc interval prolongation is considered a risk factor for adverse outcome in the non-transplant population, its predictive value in heart transplant recipients has not been studied yet. This study was conducted to determine whether prolonged QTc interval is a useful predictor of outcome in heart transplant recipients. ⋯ A relative increase in QTc interval duration of >or=10% between the first and second post-transplantation year is a strong, independent predictor of mortality in heart transplant recipients.