A large retrospective study of the UNOS database advances that elevated troponin I in selected cardiac donors is NOT associated with various adverse events. The conclusion is likely to stimulate heated discussions.
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Heart Failure - Nonischemic
Donor Troponin and Survival After Cardiac Transplantation. An Analysis of the United Network of Organ Sharing Registry
June 25, 2016
February 2, 2016
This randomized trial (NEAT-HFpEF) of 110 subjects (59 placebos) disproves, by clinical and biological markers, the utility of nitrates for exercise tolerance. This is a subset of cardiac failure patients we are likely to encounter in general cardiothoracic surgical practice.
Cardiac resynchronization therapy combined with coronary artery bypass grafting in ischaemic heart failure patients: long-term results of the RESCUE study
January 9, 2016
The authors performed a randomized control study of 178 patients with heart failure and systolic dyssynchrony who were accepted for CABG, randomizing the participants into two groups: CABG alone (n=87) and CABG + concomitant epicardial CRT (n=91). CRT was activated postoperatively.
November 5, 2015
This is a very intersting case review in which the authors describe a successful heart transplant from a 37 year old donor on VV ECMO to a 62 year old female recipeint. The authors postulate that this successful outcome may expand the available donor pool for heart transplantation.
October 8, 2015
The authors evaluated ventricular function after AR or MR in young patients with regurgitation and preoperative signs of ventricular dysfunction. Results at 18 mos were compared to a normal population. Persistent LV dysfunction was present in 85% after AR+MR and was more common than after either operation alone. Preoperative end-systolic volume pr
Surgical approach to continuous-flow left ventricular assist device explantation: A comparison of outcomes
August 14, 2015
The Texas Heart Institute reports its experience with 27 patients with prior continuous flow LVADs who had undergone varying degrees of device explantation. Although the numbers are small, the explantation methods ranged from near-complete device removal to driveline transection and removal.
January 25, 2015
This study from the University of Texas Southwestern sought to analyze the effects of mechanical unloading during prolonged LVAD support on mitochondrial mass, DNA damage response (DDR), and cardiomyocyte proliferation. Ten matched human samples of LV myocardium were analyzed before and after mechanical circulatory support.
November 15, 2014
Selzman and colleagues provide an outstanding overview of the state of the art of bridge to recovery, describing a paradigm shift that has been occurring. A consistent theme over the years is that recovery likelihood is enhanced in younger patients, those with non-ischemic cardiomyopathy, and those who have had HF for shorter durations.
Effect of Exercise and Pump Speed Modulation on Invasive Hemodynamics in Patients with Centrifugal Continuous Flow Left Ventricular Assist Devices
November 10, 2014
The effects of exercise, increasing pump speed, or both on invasive hemodynamics in centrifugal flow LVAD patients were analyzed in this small study. Findings included:
Myectomy and mitral repair through the left atrium in hypertrophic obstructive cardiomyopathy: The preferred approach for contemporary surgical candidates?
May 21, 2014
The authors present results of surgery in 12 pts for hypertrophic cardiomyopathy extending to the papillary muscles. Repair was performed through a detached anterior mitral leaflet, which was subsequently repaired. The intraventricular end-diastolic gradient was decreased by 80% postop, and mitral regurgitation that was present preop was eliminated