Permanent pacing for asystole of the donor heart after heterotopic heart transplantation.

A 41-year-old woman presented with shortness of breath and decreased exercise tolerance 1 year after heterotopic heart transplantation. She was found to have an ejection fraction of less than 20% for the native heart and severely depressed left ventricular systolic function of the donor heart. A left ventriculogram of the donor heart showed no systolic contractility.

High-risk coronary angioplasty assisted by active hemoperfusion. A feasibility study.

We assessed the effectiveness of distal hemoperfusion support during gradual, prolonged balloon inflation during percutaneous transluminal coronary angioplasty in high-risk patients. The patients were identified as having a poor left ventricular ejection fraction ( < 35%), > 50% of viable myocardium at risk percutaneous coronary balloon angioplasty, or both. A total of 64 procedures were performed in 61 patients.

Early and late mortality of patients undergoing aortic valve replacement after previous coronary artery bypass graft surgery.

Background: In a small number of patients who undergo coronary artery bypass graft surgery (CABG), a hemodynamically significant aortic valve lesion requiring aortic valve replacement (AVR) develops as they grow older. In a limited number of studies in small patient groups, high mortality has been shown in patients undergoing AVR after CABG. We undertook this study to determine the mortality risk factors for patients who undergo AVR after CABG procedures.

Recurrent left ventricular pseudoaneurysm: diagnosed by color-flow Doppler echocardiography.

The effects of left ventricular pseudoaneurysm following transmural myocardial infarction can be devastating; therefore, prompt diagnosis and surgical resection are warranted. We report a rare case of recurrent left ventricular pseudoaneurysm in which color-flow Doppler echocardiography was useful in establishing the diagnosis.

Percutaneous transluminal coronary angioplasty after cardiac transplantation.

This report describes the 1st use of percutaneous transluminal coronary angioplasty in a posttransplant patient at the Texas Heart Institute. The patient, a 44-year-old man, experienced 3 episodes of moderate allograft rejection, hypercholesterolemia, transient severe hyperglycemia, and transient severe renal insufficiency in the posttransplant period. His cholesterol levels became elevated immediately and remained between 200 and 250 mg/dL, despite treatment with gemfibrozil.