Atrial fibrillation following lung transplantation: double but not single lung transplant is associated with long-term freedom from paroxysmal atrial fibrillation.

Introduction: The cornerstone of catheter ablation for atrial fibrillation (AF) is pulmonary vein electrical isolation (PVI). Recurrent AF post-PVI is a major limitation of the procedure with PV reconnection present in most patients. Single (SLT) and double (DLT) lung transplant surgery involves a 'cut and sew' PV antral isolation analogous to a catheter-based approach providing an opportunity to assess the efficacy of durable PVI.

Pediatric experience with the VentrAssist LVAD.

Purpose: The purpose of this study is to describe the first experience of implanting a new left ventricular assist device in pediatric patients with end-stage heart failure.

Description: In two recent prospective, international, multicenter clinical trials, three children (aged
Evaluation: Despite the patients' disease severity (each child was in extremis at the time of implantation), VentrAssist (Ventracor Limited) implantation enabled each patient to be discharged home from the hospital.

Incidence of malignancies in heart and/or lung transplant recipients: a single-institution experience.

Background: The purpose of this study was to determine the incidence and type of malignancies in heart and/or lung transplant recipients at a single institution in Victoria, Australia, and to compare these findings with the non-transplant general Victorian population.

Methods: Recipients of heart and/or lung transplants at the Alfred Hospital between February 1989 and January 2004 were cross-referenced with the Victorian Cancer Registry. The medical records of all patients with a cancer diagnosis by January 1, 2005 were reviewed.

Fast-track cardiac surgery: application in an Australian setting.

In response to the current state of healthcare in Australia, our unit has employed a fast-track policy for low-risk cardiac surgery patients since January 2000. This study was designed to examine the safety and efficacy of this policy. From July 2001 to June 2004, 342 (23%) of 1,488 patients undergoing cardiac surgery were identified preoperatively as suitable for fast-track recovery.

Evaluation of sympathetic re-innervation in heterotopic cardiac transplants by iodine-123-metaiodobenzylguanidine (I-123-MIBG) imaging.

Scintigraphy using iodine-123-metaiodobenzylguanidine (I-123-MIBG) has been used to demonstrate that >50% of orthotopically transplanted hearts undergo partial cardiac sympathetic re-innervation and that this occurs no earlier than 1 year post-transplant. This study used planar and singe-photon emission computed tomography (SPECT) I-123 MIBG scintigraphy to show that cardiac re-innervation was not detectable in any of the 8 patients studied 1.1 to 6.

Demonstrating time sequence and extent of sustained decrease in native heart ejection fraction after heterotopic transplantation.

Background: In this study we investigate the time sequence and extent of the sustained decrease in native heart ejection fraction (EF) after heterotopic heart transplantation (HHTx) when using gated cardiac blood pool scanning (GCBPS) and transthoracic echocardiography (TTE) One case report of 2 patients used post-operative GCBPS and TTE and found a significant deterioration in native heart EF post-operatively over the course of several years. Comparison with pre-operative measurements using these techniques in a series of patients has not been performed previously.

Methods: Thirteen of 16 HHTx patients with adequate pre- and post-operative GCBPS follow-up were included in this study.

Sirolimus in de novo heart transplant recipients reduces acute rejection and prevents coronary artery disease at 2 years: a randomized clinical trial.

Background: Sirolimus reduces acute rejection in renal transplant recipients and prevents vasculopathy in nonhuman primates and in-stent restenosis in humans. Its effects on rejection and transplant vasculopathy in human heart transplant recipients are unknown.

Methods And Results: In a randomized, open-label study, sirolimus was compared with azathioprine in combination with cyclosporine and steroids administered from the time of cardiac transplantation.