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. · Feb 2019
Survival in pulmonary hypertension due to chronic lung disease: Influence of low diffusion capacity of the lungs for carbon monoxide.
Patients with pulmonary hypertension (PH) due to chronic lung disease (Group 3 PH) have poor long-term outcomes. However, predictors of survival in Group 3 PH are not well described. ⋯ Low DLCO is a predictor of mortality and should be used to risk-stratify Group 3 PH patients.
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J. Heart Lung Transplant. · Feb 2019
Multicenter StudyThe Society of Thoracic Surgeons Intermacs database annual report: Evolving indications, outcomes, and scientific partnerships.
The Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs), a joint effort among the National Heart, Lung, and Blood Institute, the Food and Drug Administration, the Centers for Medicare and Medicaid Services, and others, was established in 2005 at the University of Alabama at Birmingham. The registry examined clinical outcomes and quality-of-life metrics of patients who received an Food and Drug Administration-approved durable mechanical circulatory support (MCS) device to treat advanced heart failure. On January 1, 2018, the Intermacs Database became part of The Society of Thoracic Surgeons National Database, providing additional resources for quality assessment and improvement and scientific advancement. ⋯ With the evolution of MCS, patient phenotype and outcomes are also changing over time. CF LVAD support is increasingly being used in the less ill patient phenotype and more patients are supported for destination therapy. Mean survival is now approaching 5 years, but adverse events, especially neurologic events, continue to have a detrimental impact on the success of CF LVAD support.
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J. Heart Lung Transplant. · Jan 2019
Randomized Controlled Trial Multicenter StudySafety and tolerability of transition from inhaled treprostinil to oral selexipag in pulmonary arterial hypertension: Results from the TRANSIT-1 study.
A long-term trial showed that the oral prostacyclin (PGl2) receptor (IP) agonist, selexipag, delayed disease progression in patients with pulmonary arterial hypertension (PAH). Transition to selexipag in patients treated with more burdensome inhaled therapies that target the prostacyclin pathway may be considered by patients and physicians. The Phase 3b, prospective, open-label TRANSIT-1 (Tolerability and Safety of the Transition From Inhaled Treprostinil to Oral Selexipag in Patients With Pulmonary Arterial Hypertension) study evaluated the safety and tolerability of transition from inhaled treprostinil to oral selexipag. ⋯ NCT02471183.
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J. Heart Lung Transplant. · Jan 2019
Native upper lobe-sparing living-donor lobar lung transplantation maximizes respiratory function of the donor graft.
We have developed a novel method for native upper lobe-sparing living-donor lobar lung transplantation (LDLLT) to overcome a small-for-size graft in standard LDLLT with acceptable results. We hypothesized that grafts implanted with this procedure might work more efficiently than those in standard lobe transplantation. ⋯ The grafts in lobe-sparing LDLLT functioned more effectively than those in standard LDLLT. This advantage was associated with the improvement of pulmonary functions.
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J. Heart Lung Transplant. · Dec 2018
Multicenter StudyAn international multicenter experience of biventricular support with HeartMate 3 ventricular assist systems.
Significant right ventricular failure accompanying left ventricular failure was treated by implantation of the fully magnetically levitated centrifugal HeartMate 3 ventricular assist device as biventricular (BiVAD) support in 14 patients at 6 medical centers worldwide. The clinical details of this first multicenter experience are presented. Nine of these patients (64%) were alive as of January 1, 2018. Eight of the 9 have continued on BiVAD support for 95 to 636 (mean 266) days: 7 at home, and 1 successfully transplanted after 98 days of support.