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Journal and News Scan
The authors explored readmission rates for heart failure after MV repair/replacement in the US Medicare population as a means for assessing quality. The preop heart failure rate in this population was 61%. Readmission rates were 25% at 30 days and 78% at 5 years; they were substantially higher for those with preop heart failure and were higher for those undergoing valve repair rather than valve replacement.
Left ventricular assist devices (LVADs) are increasingly used for the treatment of end-stage congestive heart failure, both as a bridge to transplantation and as destination therapy (1). The HeartWare HVAD (HeartWare Inc, Framingham, MA, USA) is a continuous centrifugal-flow left ventricular assist device with a magnetic levitating rotor pump. The pump weighs just 140 g and its small design allows for intra-pericardial placement. It is powered by two portable batteries that connect to the pump via a driveline tunneled through the abdominal wall, and these can be worn on a belt, allowing out of hospital support (2). The HVAD is currently indicated for use in patients with refractory end stage congestive heart failure. We outline two techniques for implanting the HeartWare HVAD: via a full median sternotomy, and using minimal access incision
The German Aortic Valve Registry comprises data of 78 centers on conventional, transvascular and transapical valve replacements. After stratification for EuroScore and the German AV score, mortality was comparable with either therapy even for high-risk groups.
This paper reviews the various techniques of 3D bioprinting with special attention to generation of tubes to be used as artificial blood vessels.
Ex-vivo lung reperfusion was employed to recondition marginal or rejected lung grafts. Eight out of 11 lungs were deemed suitable for transplantation after treatment. Results with regard to primary graft dysfunction were comparable to those of 28 regular transplantations.
Saphenous vein graft failure after coronary artery bypass surgery
Circulation, 10/21/2014 Clinical Article
Hess CN, et al. – Coronary artery bypass grafting success is limited by vein graft failure (VGF). Understanding the factors associated with VGF may improve patient outcomes. VGF is common and associated with patient and surgical factors. These findings may help identify patients with risk factors for VGF and inform the development of interventions to reduce VGF.
All about James Hello, my name is James Lewis. I am 4 years old. I have been waiting for a heart transplant for 9 months. I have a heart condition called restrictive cardiomyopathy, which means that my heart does not work properly anymore. My Mummy, Kate is going to tell my story.
In July 2013, out of the blue, we had the shocking news no parent ever wants to hear. Our youngest son James was diagnosed with restrictive cardiomyopathy and at best might live for another two years or so. The only option would be a heart transplant. I said to the consultant, how can I pray for a new heart for James when someone else has to lose a child?
We went to meet the transplant team at Great Ormond Street Children's Hospital, and soon learnt that even with a successful heart transplant, James' journey would likely be shorter than you would hope, that the average life expectancy is 15-20 years. But we decided that life is for living, and that James could have a remarkable, if shorter life.
I decided at that point that I wanted to make something positive happen out of a very scary and unpredictable situation. It became apparent that there is a massive shortage of child donors, and I want to raise awareness about this.
- In 2012, 48% of parents asked to donate their child's organs said no.
- 97% people would take an organ if they needed one, yet only around a third of people are signed up to the organ donor register.
Many parents do not realise that they can sign their children up to the organ donor register.
Children are very receptive to the idea of organ donation. They see it as recycling. For parents who bravely say yes, in a terrible, traumatic situation of losing their child, they have the knowledge that their child has not died in vain.
One person's donated organs can save the lives of 7 others, and transform the lives of another 2 people.
I have been working with a charity called Live Life Then Give Life www.lltgl.org to raise awareness about organ donation, particularly in children. The work we are doing is part of the Let Love Live On campaign. Every child is part of a family, organ donation affects everyone.
In this review, the authors describe alternative treatments for hypertrophic cardiomyopathy (HCM). The most important evidence comparing alcohol septal ablation (ASA) and surgical myectomy is discussed. The authors conclude that surgery is most consistent in achieving optimal hemodynamic results, quality of life and longevity. ASA however is a good alternative in older patients with more comorbidities.
The Heart and Lung Transplant team of St. Vincent’s hospital (Sydney, Australia) have successfully transplanted “dead” hearts into three patients. The donor hearts had stopped beating for 20 minutes, but were kept viable by being immersed in a preservation solution. The hearts were then restarted and kept beating in a specially developed circuit, called a “heart in a box.”
Retrospective study on 102 consecutive asymptomatic or mildly symptomatic patients with no left ventricular dysfunction and with degenerative mitral regurgitation (MR) who underwent mitral valve surgery in three centers. The authors looked into the usefulness of exercise stress echocardiography in this group of patients to predict postoperative cardiovascular events. The findings show that the development of exercise-induced pulmonary hypertension (PHT) is a major risk factor for cardiovascular events following mitral valve surgery, regardless of symptom onset during the preoperative course. The results of this study suggest that asymptomatic patients with exercise-induced PHT may benefit from early elective surgical intervention.