Pulmonary Embolism in COVID-19 Treated with VA-ECLS and Catheter tPA.

Background: Novel coronavirus 2019 (COVID-19) has been the focus of the medical world since being declared a pandemic in March 2020. While the pathogenesis and heterogeneity of COVID-19 manifestations is still not fully understood, viral evasion of cellular immune responses and inflammatory dysregulation are believed to play essential roles in disease progression and severity.

Case Presentation: We present the first case of a patient with COVID-19 with massive pulmonary embolism treated successfully with systemic thrombolysis, VA-ECLS, and bail out catheter directed thrombolysis.

Left ventricular assist device as 'bridge to weight loss' prior to transplantation in obese patients with advanced heart failure.

Background: Obesity is a risk factor for heart failure (HF) and associated with poor outcomes after cardiac transplantation. We assessed change in total body weight, morbidity and mortality in obese heart failure patients after implantation of a left ventricular assist device (LVAD) compared to medical management.

Material/methods: Nineteen patients (9 females, age 51.

Esophageal motor dysfunction and gastroesophageal reflux are prevalent in lung transplant candidates.

Background: Gastroesophageal reflux and aspiration contribute to the development of bronchiolitis obliterans and accelerate graft deterioration after lung transplantation (LTx). We evaluated LTx candidates for esophageal motor abnormalities and gastroesophageal reflux.

Methods: Consecutive patients evaluated for LTx underwent 24-hour pH monitoring using a dual-channel pH probe and high-resolution esophageal manometry.

Maximal care considerations when treating patients with end-stage heart failure: ethical and procedural quandaries in management of the very sick.

Deciding who should receive maximal technological treatment options and who should not represents an ethical, moral, psychological and medico-legal challenge for health care providers. Especially in patients with chronic heart failure, the ethical and medico-legal issues associated with providing maximal possible care or withholding the same are coming to the forefront. Procedures, such as cardiac transplantation, have strict criteria for adequate candidacy.

Heart transplantation using bivalirudin as anticoagulant.

We present the case of a man with heparin-induced thrombocytopenia (HIT) and acute idiopathic decompensated cardiomyopathy who underwent successful heart transplantation with the use of bivalirudin as anticoagulant.

Complicated ruptured sinus of Valsalva: cardiac computed tomographic angiography (64 slice) predicts surgical appearance and obviates need for invasive cardiac catheterization.

We present a case report of a ruptured sinus of Valsalva aneurysm (SVA) that presented as aortic insufficiency following bacterial endocarditits in a cardiac transplant patient. Cardiac computed tomographic angiography (CCTA) including volume rendered images predicted the appearance of the fistula entrance and defined spatial relationships facilitating the surgical approach. CCTA ability to define the coronary anatomy obviated the need for invasive coronary angiography.

Heart allograft transplanted twice.

We present the case of a man who underwent successful heart transplantation with an allograft that was obtained from a donor who had already received heart transplantation.

Histopathology and transmurality of acute microwave lesions on the beating human atrium.

Microwave energy allows thoracoscopic beating-heart ablation for the treatment of atrial fibrillation. However, there is a paucity of data on the histologic effects of microwave energy on the beating human heart. This study aims to histopathologically characterize microwave lesions on the beating human atrium.

Successful bilateral lung transplant outcomes in recipients 61 years of age and older.

Background: Controversy exists regarding the optimal use of bilateral lung transplant (BLT) in older recipients in diseases where either single or bilateral transplant is appropriate. International Society for Heart and Lung Transplant (ISHLT) guidelines suggest an upper age limit of 60 for BLT, despite limited data regarding outcomes with BLT in patients over 60. We hypothesize that BLT offers comparable, if not superior, clinical outcomes to SLT in all patients independent of recipient age.

Left ventricular assist device as destination therapy in doxorubicin-induced cardiomyopathy.

Doxorubicin-induced cardiomyopathy is not uncommon and may progress to end-stage heart failure. Treatment of this condition with heart transplantation, however, requires that the primary malignancy be deemed "cured." We present the case of a 55- year-old woman who had doxorubicin-induced cardiomyopathy and non-Hodgkin's lymphoma.

Noninvasive, near infrared spectroscopic-measured muscle pH and PO2 indicate tissue perfusion for cardiac surgical patients undergoing cardiopulmonary bypass.

Objective: To determine whether near infrared spectroscopic measurement of tissue pH and Po2 has sufficient accuracy to assess variation in tissue perfusion resulting from changes in blood pressure and metabolic demand during cardiopulmonary bypass.

Design: Prospective clinical study.

Setting: Academic medical center.

Staged laparoscopic splenectomy and valve replacement in splenic abscess and infective endocarditis.

Splenic abscess is a rare clinical entity that is most commonly associated with infective endocarditis. Valve replacement in the setting of an unaddressed splenic abscess is associated with a high incidence of prosthetic valve infection and death. We describe 2 patients with infective endocarditis and splenic abscess treated by laparoscopic splenectomy followed by valve replacement.