This case report describes the management of a 30-year-old male patient with a history of an advanced nonseminomatous germ cell tumor, hip fracture complicated by extensive deep vein thrombosis and pulmonary embolism, and on apixaban presenting with asymptomatic intracardiac teratoma and abdominopelvic metastases. Multidisciplinary intervention, including successful surgical excision of the intracardiac mass, highlights the importance of coordinated care and vigilant follow-up in optimizing patient outcomes and preventing life-threatening complications.
View Article and Find Full Text PDFThis report discusses the case of a 57-year-old woman with a history of breast cancer and gastric cancer, germline CDH1 gene mutation, who presented to the hospital with syncope. Diagnostic workup revealed a mass in the right ventricular outflow tract. Transcatheter biopsy suggested papillary fibroelastoma, which was confirmed with surgical pathology.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
November 2024
Objectives: Optimal blood pressure goals during cardiopulmonary bypass (CPB) remain uncertain and new metrics to individualize perfusion targets are needed. Critical closing pressure (Pcrit) is a fundamental property of the arterial circulation related to vascular tone and represents the outflow pressure impacting flow across the systemic circulation. We examined Pcrit as a prognostic marker of acute kidney injury (AKI).
View Article and Find Full Text PDFBiofilm is a structurally-connected microbial community, covered by a self-produced polymeric matrix and adhered to biotic or abiotic surfaces. This study aimed to evaluate the occurrence of biofilm-producing antibiotic-resistant bacteria in water from distribution systems. Water samples were taken from 32 tanks across Ondo City and Akure metropolis, Nigeria.
View Article and Find Full Text PDFBackground: Donation after circulatory death (DCD) and ex-vivo lung perfusion (EVLP) have been adopted to expand the donor pool in lung transplantation, but outcomes data have been conflicting. This study explores outcomes of DCD and EVLP lung transplantation in the modern era.
Methods: The United Network for Organ Sharing database was queried for adult lung transplants from January 1, 2015 to March 1, 2023.
Background: Transplantation using hearts obtained through donation after circulatory death (DCD) is increasing, but data on recipient renal outcomes are limited.
Methods And Results: Patients at a single institution who underwent heart transplantation using organs procured through DCD or donation after brain death (DBD) from April 2016 to August 2022 were included in this retrospective cohort study. Hemodynamic measures were collected via right heart catheterization performed 1 week after transplantation.
Transplant Direct
September 2024
Background: The number of patients waiting for heart transplant far exceeds the number of hearts available. Donation after circulatory death (DCD) combined with machine perfusion can increase the number of transplantable hearts by as much as 48%. Emerging studies also suggest machine perfusion could enable allograft "reconditioning" to optimize outcomes.
View Article and Find Full Text PDFImportance: There are limited data on the association of sex with the incidence of postoperative atrial fibrillation (poAF) and subsequent long-term mortality after cardiac surgery.
Objective: To evaluate whether the incidence of poAF and associated long-term mortality after cardiac surgery differ by sex.
Design, Setting, And Participants: This retrospective cohort study was conducted at 2 tertiary care centers in Massachusetts from January 1, 2002, until October 1, 2016, with follow-up until December 1, 2022.
Ex vivo machine perfusion or normothermic machine perfusion is a preservation method that has gained great importance in the transplantation field. Despite the immense opportunity for assessment due to the beating state of the heart, current clinical practice depends on limited metabolic trends for graft evaluation. Hemodynamic measurements obtained from left ventricular loading have garnered significant attention within the field due to their potential as objective assessment parameters.
View Article and Find Full Text PDFBackground: This study examined the association between cardiopulmonary bypass (CPB) hematocrit and postoperative acute renal failure (ARF) in patients undergoing aortic arch surgery with hypothermic circulatory arrest.
Methods: The Society of Thoracic Surgeons Adult Cardiac Surgery Database was queried from 2011 to 2019 for patients undergoing aortic arch surgery with hypothermic circulatory arrest. A multivariable logistic regression model estimated the adjusted odds of postoperative ARF on the basis of CPB hematocrit.
Purpose Of The Review: The current lack of objective and quantitative assessment techniques to determine cardiac graft relative viability results in risk-averse decision-making, which negatively impact the utilization of cardiac grafts. The purpose of this review is to highlight the current deficiencies in cardiac allograft assessment before focusing on novel cardiac assessment techniques that exploit conventional and emerging imaging modalities, including ultrasound, magnetic resonance, and spectroscopy.
Recent Findings: Extensive work is ongoing by the scientific community to identify improved objective metrics and tools for cardiac graft assessment, with the goal to safely increasing the number and proportion of hearts accepted for transplantation.
Despite important advancements in the diagnosis and treatment of cardiovascular diseases (CVDs), the field is in urgent need of increased research and scientific advancement. As a result, innovation, improvement and/or repurposing of the available research toolset can provide improved testbeds for research advancement. Langendorff perfusion is an extremely valuable research technique for the field of CVD research that can be modified to accommodate a wide array of experimental needs.
View Article and Find Full Text PDFObjective: To assess the effects of the 2020 United States Public Health Service (PHS) "Increased Risk" Guidelines update.
Background: Donors labeled as "Increased Risk" for transmission of infectious diseases have been found to have decreased organ utilization rates despite no significant impact on recipient survival. Recently, the PHS provided an updated guideline focused on "Increased Risk" organ donors, which included the removal of the "Increased Risk" label and the elimination of the separate informed consent form, although the actual increased risk status of donors is still ultimately transmitted to transplant physicians.
A 72-year-old man with interstitial lung disease underwent a planned single lung transplantation. His late postoperative course was notable for hemodynamic deterioration, after which severe right pulmonary vein anastomotic stenosis was identified via echocardiogram. The case highlights a rare complication of lung transplantation diagnosed by using transesophageal echocardiogram.
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