Comparison of the efficacy and safety of pravastatin and simvastatin in heart transplantation.

Aims: Data on the safety and efficacy of HMG CoA reductase inhibitors in managing dyslipidemia in heart transplant recipients is inadequate. We undertook this study to evaluate the comparative safety and efficacy of simvastatin and pravastatin in lowering lipids in heart transplant recipients.

Methodology: Forty eight patients (38 males) who received heart transplantation between 1995 and 1997, and who had no contraindications to statin therapy or history of myopathy were randomized to receive either pravastatin (n=24) or simvastatin (n=24) for six months.

The unique management of refractory advanced systolic heart failure.

Advanced systolic heart failure refractory to ambulatory pharmacotherapy continues to be a clinical dilemma with increasing incidence and prevalence. By establishing the presence of signs and symptoms, clinicians could better evaluate hemodynamic perturbations, therefore targeting them through the use of intravenous diuretics, intravenous vasodilators, and intravenous inotropic therapy. This review focuses on the unique features that characterize advanced heart failure, and discusses the special clinical considerations in managing this morbid entity.

Myoblast transplantation in the porcine model: a potential technique for myocardial repair.

The use of transgenic cells transplanted in syngeneic rodents has shown modest success, but allogeneic and xenogeneic transplants have not been uniformly successful. To assess the feasibility of xenogeneic and allogeneic myoblast transplantation, we subjected seven adult swine to transplantation of murine atrial tumor cells (xenogeneic), neonatal porcine myocytes (allogeneic), and human fetal cardiomyocytes into the left ventricular wall. After general anesthesia, isolated cells were injected along the anterior and posterior walls of the porcine left ventricle.

High-risk surgery as an alternative to transplantation.

Between April 1992 and April 1994, 185 patients were waiting for a cardiac transplant at our institution. Transplantation was performed in 118 of these patients. Twenty-six patients (14%) died while awaiting a donor heart: 13 of these were in the intensive care unit on multiple inotropic medications, mechanical support, or both; another 13 were either in the hospital on a single inotropic medication or at home with or without inotropic support.