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 2006
Case ReportsIntraperitoneal HeartMate left ventricular assist device placement after endovascular repair of an abdominal aortic aneurysm.
The presence of an abdominal aortic aneurysm (AAA) can be a contraindication to placement of a HeartMate left ventricular assist device (LVAD) for end-stage heart failure. We describe a 65-year-old patient who underwent endovascular repair of an AAA before placement of a LVAD as destination therapy for end-stage heart failure. This case is the first report of endovascular AAA repair before VAD placement. It not only demonstrates the utility of endovascular AAA repair in patients with undue co-morbidities, but also that the presence of an AAA should not be a contraindication to LVAD placement, if corrected.
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J. Heart Lung Transplant. · Feb 2006
Tissue Doppler imaging in patients with advanced heart failure: relation to functional class and prognosis.
Tissue Doppler imaging (TDI) provides rapid assessment of systolic and diastolic myocardial function. However, the added value of TDI to standard Doppler echocardiographic measurements in predicting symptoms and outcome of advanced heart failure remains unknown. ⋯ Conventional Doppler indices and TDI parameters correlated with functional class in patients with advanced heart failure. The E/E' ratio, which probably reflects high LV end-diastolic pressure, was the best measure for differentiating patients with functional class III and IV, and it also correlated with cardiac mortality and hospitalization for worsening heart failure, thereby providing additional value to standard echocardiographic measures.
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J. Heart Lung Transplant. · Feb 2006
Health-related quality-of-life determinants in lung transplantation.
In light of recent reviews, we examined the effect of individual and clinical factors, associated with lung transplantation (LTx), on health-related quality of life (HRQL). ⋯ Clinical events leading to hospitalization limit some HRQL domains. Different factors influence the physical, social and mental health domains, and thus future studies should focus on domain-specific variables to optimize HRQL. The HRQL benefit conferred from LTx renders it a worthwhile option for end-stage lung disease patients with important physical limitations.
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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.