Background: Coal worker's pneumoconiosis (CWP) poses a significant burden on affected individuals and is associated with increased morbidity and mortality. Lung transplantation (LT) is the only effective treatment for this progressive and fatal lung disease. This study aims to evaluate the outcomes of patients who have undergone LT for primary diagnosis of CWP.
View Article and Find Full Text PDFcomplex is a nontuberculous that has been associated with a wide range of infections, including the skin and soft tissues, central nervous system, and pulmonary system. We discuss the case of a 66-year-old male with a history of coal worker's pneumoconiosis who had undergone a bilateral lung transplant eight years prior and presented with drainage from his right chest incision site. He underwent operative exploration and drainage of the wound.
View Article and Find Full Text PDFThe thoracic aorta is a dynamic structure composed of the aortic root, ascending aorta, aortic arch, and descending aorta. It is subject to the pressure and volume of the cardiac cycle and susceptible to atherosclerotic and aneurysmal changes. With these changes, the risk for acute aortic syndromes increases, thus creating the impetus for earlier interventions.
View Article and Find Full Text PDFIntroduction: Anti-thymocyte globulin (ATG) is a polyclonal antibody formulation which has been used as a second-line therapy for chronic lung allograft dysfunction (CLAD). Limited data exist evaluating its efficacy; however, several single-center retrospective studies have variably demonstrated either improvement or stabilization of spirometry parameters after administration of ATG. ATG has been in use at UT Southwestern for treatment of CLAD since at least 2010; here, we seek to evaluate the effectiveness of this intervention at our center.
View Article and Find Full Text PDFIn efforts to decrease the mortality on the waiting list for lung transplantation, alternatives to increase the donor pool have been explored. Caution must be used when accepting donor lungs with pulmonary embolism (PE), as prior evidence has shown mixed results after transplantation of donor lungs with PE. However, the mere diagnosis of PE on imaging should not be the sole reason for the exclusion of these donors for transplant, and they should be reviewed as any other donor.
View Article and Find Full Text PDFThromboembolic events are the third leading cardiovascular diagnosis following stroke and myocardial infarction. In the United States, 300,000 to 600,000 people per year are diagnosed with venous thromboembolism, either deep venous thrombosis or pulmonary embolism (PE). Of those patients, thousands die from PE despite heightened vigilance and improved therapies.
View Article and Find Full Text PDFDelayed cardiac tamponade after cardiac surgery is a rare complication with significant diagnostic challenges. The recurrence of cardiac tamponade physiology after initial intervention creates another degree of difficulty in the management of already medically complex patients. We present the case of a 65-year-old male who underwent four-vessel coronary artery bypass grafting that was complicated by the delayed presentation of cardiac tamponade requiring mediastinal exploration.
View Article and Find Full Text PDFAnastomoses of the coronary buttons are the Achilles' heel of the modified Bentall procedure (MBP) for the repair of the aortic root and ascending aorta. We present a rare case of post-MBP right coronary artery button pseudoaneurysm in a 30-year-old man. The contained leak, attributed to a pseudoknot in the polypropylene suture, was visualized via computed tomography angiography and transesophageal echocardiogram and repaired under deep hypothermic circulatory arrest.
View Article and Find Full Text PDFPurpose: This pilot study implemented Creating Opportunities for Personal Empowerment (COPE), a cognitive behavioral therapy (CBT) intervention, in the perioperative care of patients with advanced heart failure awaiting left ventricular assist device (LVAD) implantation.
Methods: Using a quasi-experimental study design, the patients were screened for anxiety and depression using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) screening tools. If patients scored 5 or greater on either tool, they received COPE.
Kartagener's syndrome (KS) is a genetic disorder and a subgroup of primary ciliary dyskinesia characterized by situs inversus, chronic sinusitis and bronchiectasis. Patients with KS can develop severe bronchiectasis with end-stage lung disease due to recurrent pulmonary infections. Lung transplantation is a treatment option with good outcomes reported in the literature.
View Article and Find Full Text PDFCoronary vasospasm is a known complication after coronary artery bypass grafting surgery but has rarely been described in non-coronary cardiac operations. We report the case of a 51-year-old male with nonischemic cardiomyopathy and paroxysmal atrial fibrillation. He presented with severe mitral and tricuspid regurgitation and was taken for mitral valve replacement, tricuspid valve repair, and Maze procedure.
View Article and Find Full Text PDFThe population of elderly adults is increasing globally. It has been projected that the population of adults aged 65 years will increase by approximately 80% by 2050 in the United States. Similarly, the elderly population is rising in other countries; a notable example being Japan where approximately 30% of the population are aged above 65 years.
View Article and Find Full Text PDFAortic valvular disease, including aortic stenosis and aortic regurgitation, is increasingly common with age. Due to the aging population, more elderly patients are presenting with aortic valve pathology and expectations for prompt diagnosis and efficacious treatment. The current paradigm for aortic valve disease is based on surgical or interventional therapy.
View Article and Find Full Text PDFExtracorporeal membrane oxygenation (ECMO) is a lifesaving intervention in critically ill patients with cardiorespiratory failure. ECMO in patients with cancer is generally contraindicated not only to conserve precious resources and properly direct use but also due to a multitude of associated physiological derangements in these subsets of patients. ECMO in patients with disseminated cancer is an automatic rule-out except for anecdotal reports.
View Article and Find Full Text PDFIndian J Thorac Cardiovasc Surg
November 2022
Ventral hernias following left ventricular assist device (LVAD) placement are rare. With the improvement in technology, and miniaturization of devices associated with intrapericardial placement, these complications have largely been abolished. The mere presence of a large ventral hernia should not exclude recipients from being candidates for orthotopic heart transplantation.
View Article and Find Full Text PDFHunter syndrome is a rare disorder in which affected patients have significant airway abnormalities (macroglossia, small mouth opening, and supraglottic narrowing) that complicate their management. Deposition of glycosaminoglycans in the heart leads to cardiomyopathy, and cardiac valve dysplasia that can lead to valvular stenosis or regurgitation or both, necessitating valve replacement. Management of patients with Hunter syndrome is complex and needs a multidisciplinary team approach.
View Article and Find Full Text PDFDevelopments in endovascular therapies have made stenting a common practice in the treatment of peripheral vascular diseases, including venous disorders such as May-Thurner syndrome. The placement of a stent in the venous system carries the risk of stent migration which although small occurs with a 3% incidence rate and can be life-threatening given the risk of pulmonary infarction, tricuspid regurgitation, and right-sided heart failure. Herein we report a case of stent embolization from the common iliac vein into the right side of the heart causing tricuspid regurgitation.
View Article and Find Full Text PDFPulmonary embolectomy has a chequered history but the quest to surgically treat a patient diagnosed with pulmonary embolism effectively spurred the development of cardiopulmonary bypass and a new dawn for cardiac surgery. The advent of cardiopulmonary bypass, extracorporeal membrane oxygenation, and computed tomography pulmonary angiogram has allowed rapid diagnosis and made surgical pulmonary embolectomy a relatively safe procedure that should be considered when indicated. Pulmonary emboli in donor lungs, often get rejected for transplantation.
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