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 2013
Comparative StudyImpact of concomitant cardiac procedures performed during implantation of long-term left ventricular assist devices.
There is a paucity of data evaluating the effect of performing a concomitant cardiac procedure (CCP) on peri-operative survival in patients undergoing implantation of long-term left ventricular assist devices (LVADs). The objective of this study was to review our single-institutional experience with patients who underwent a CCP during implantation of a long-term continuous-flow LVAD. ⋯ CCPs performed during implantation of a long-term continuous-flow LVADs does not increase peri-operative or mid-term mortality. In addition, unlike previous reports, there was no additive procedural risk for patients undergoing concomitant aortic valve repair or replacement.
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J. Heart Lung Transplant. · Dec 2013
Survival in pulmonary arterial hypertension patients awaiting lung transplantation.
Pulmonary arterial hypertension (PAH) is a progressive disease with lung transplantation as the only option for those patients refractory to medical therapy. Although several equations have been developed to predict PAH patient survival, it is unclear whether they can predict survival for patients awaiting transplantation. ⋯ Current prediction models overestimate survival for PAH patients listed for transplant in the LAS era. This new survival equation can help guide clinicians caring for PAH patients with progression of disease requiring transplant.
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J. Heart Lung Transplant. · Dec 2013
Pulmonary vascular abnormalities in chronic obstructive pulmonary disease undergoing lung transplant.
Little is known about the structure and function relationships of pulmonary vessels in the most severe chronic obstructive pulmonary disease (COPD) spectrum. We investigated morphometric, cellular, and physiologic characteristics of pulmonary arteries from COPD patients undergoing bilateral lung transplant. ⋯ In end-stage COPD patients undergoing lung transplant, pulmonary vascular involvement is unexpectedly modest, with low-grade endothelial dysfunction. In this sub-set of COPD patients, pulmonary emphysema may constitute the major determinant of the presence of pulmonary hypertension.
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J. Heart Lung Transplant. · Nov 2013
Comparative StudyA relevant experimental model for human bronchiolitis obliterans syndrome.
The long-term success of human lung transplantation is limited by the development of bronchiolitis obliterans syndrome. Acute rejection episodes and infections are important risk factors and seem to play major pathogenic roles. We established a relevant experimental model that mimics important aspects of human bronchiolitis obliterans syndrome. ⋯ Our experimental model mirrors key aspects of human bronchiolitis obliterans syndrome. It will be useful to elucidate its pathogenesis and to develop therapeutic approaches improving the long-term outcome of human lung transplantation.
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J. Heart Lung Transplant. · Nov 2013
Multicenter Study Observational StudyTreatment of patients with pulmonary arterial hypertension at the time of death or deterioration to functional class IV: insights from the REVEAL Registry.
Current guidelines recommend intravenous prostacyclin as first-line therapy for patients with pulmonary arterial hypertension (PAH) in New York Heart Association/World Health Organization functional class (FC) IV, or combination therapy for patients in any FC who do not respond to monotherapy. We investigated the aggressiveness of therapy in patients enrolled in the REVEAL (Registry to Evaluate Early and Long-Term PAH Disease Management) Registry who deteriorated to FC IV or died. ⋯ Intravenous prostacyclin and combination therapy are not consistently used in the most seriously ill patients enrolled in REVEAL after being assessed as FC IV or at the time of death.