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. · Oct 2014
Treatment with inotropes and related prognosis in acute heart failure: contemporary data from the Italian Network on Heart Failure (IN-HF) Outcome registry.
In the recent Italian Network on Heart Failure (IN-HF) Outcome registry, including 1,855 patients with acute heart failure (AHF), we reviewed the use of inotropes and their prognostic implication on in-hospital and 12-month mortality. ⋯ Inotropes were used in nearly 20% of the patient admitted for AHF, and this treatment was associated with a short-term to medium-term poor prognosis. An inappropriate use of inotropes in patients with normal to high SBP, and presumably preserved cardiac output, may have significantly contributed to affect the all-group outcome.
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J. Heart Lung Transplant. · Oct 2014
Substance abuse at the time of left ventricular assist device implantation is associated with increased mortality.
Advanced heart failure teams are often faced with the decision of whether or not to offer a left ventricular assist device (LVAD) to patients who have end-stage heart failure and recent or ongoing substance abuse. The outcomes of these patients after LVAD implantation are unknown. ⋯ Active substance abuse in patients who received an LVAD was associated with increased mortality and overall poor outcomes. Larger scale data will be needed to confirm these findings and to inform decision-making in this population.
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J. Heart Lung Transplant. · Oct 2014
Comparative StudyFactors determining post-operative readmissions after left ventricular assist device implantation.
In the current era of extensive healthcare reform, there has been a heightened focus on the frequency and cause for readmissions within 30 days of discharge given that readmissions are not reimbursed by most providers. The aim of our study was to determine the frequency, etiology and patterns of 30-day readmissions among recipients of continuous-flow left ventricular assist devices (LVADs) at our institution as well to determine whether there were any significant predictors of readmission. ⋯ Our experience indicates that 30-day readmission rates after LVAD implantation remain relatively high, with most occurring within 10 days of discharge. Recurrent heart failure and GIB were the most common causes of post-operative rehospitalization. In addition, GIB during the index hospitalization was a significant predictor of 30-day readmission.
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J. Heart Lung Transplant. · Oct 2014
The physician becomes the patient: how my breast cancer journey taught me to be a better doctor.
On April 1, 2013, I received the shocking news that I had Stage II breast cancer. Despite my medical knowledge, at the time of my diagnosis, I was unable to grasp the magnitude of the ordeal I would experience. However I also received an unexpected gift: being a patient made me a better person and a better doctor.