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In the Twilight of Evidence: Is Bypass Surgery Still on the Table for Cardiac Allograft Vasculopathy?
J Clin Med
December 2024
Department of Cardiology, University Hospital Zurich, 8091 Zurich, Switzerland.
Cardiac allograft vasculopathy (CAV) is a major prognosis-limiting factor in patients undergoing orthotopic heart transplantation (HT). Due to the diffuse involvement of the coronary tree, CAV lesions are often not amenable to percutaneous coronary intervention (PCI), leaving coronary artery bypass grafting (CABG) and retransplantation as primary revascularization options. : The latest guidelines from the International Society for Heart and Lung Transplantation (ISHLT) recognize CABG as a viable option but with a downgraded strength of recommendation.
View Article and Find Full Text PDFEfficiency at Heart: Navigating the Hybrid Single-Ventricle Pathway.
Ann Thorac Surg Short Rep
September 2024
Department of Surgery, The Ohio State University, Columbus, Ohio.
Background: Single-ventricle cardiac defects (SVCDs) are among of the most health care resource-intensive congenital diseases. Although SVCDs are traditionally palliated using the Norwood pathway, in the last 2 decades select programs have used the hybrid strategy, which redistributes the operative and interstage risks. This study sought to characterize resource use for a cohort of patients with hybrid-palliated SVCD.
View Article and Find Full Text PDFOrthotopic Heart Transplantation in a Patient With Hypertrophic Cardiomyopathy and Marfan Syndrome.
Ann Thorac Surg Short Rep
June 2024
Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Illinois.
A 24-year-old man with Marfan syndrome and heart failure from hypertrophic cardiomyopathy was referred to our institution in cardiogenic shock for advanced therapies. He was supported by a femoral intra-aortic balloon pump, then bridged to orthotopic heart transplantation. This is a report of an orthotopic heart transplantation in a patient with both Marfan syndrome and heart failure from hypertrophic cardiomyopathy.
View Article and Find Full Text PDFPreservation of Cardiac Xenografts in a Model of Infant Human Cardiac Transplantation.
Xenotransplantation
January 2025
Division of Cardiac Surgery, Department of Surgery, Children's Hospital of Los Angeles, Los Angeles, California, USA.
Introduction: There is no standard protocol for management of organ preservation for orthotopic, life-sustaining cardiac xenotransplantation, particularly for hearts from pediatric sized donors. Standard techniques and solutions successful in human allotransplantation are not viable. We theorized that a solution commonly used in reparative cardiac surgery in human children would suffice by exploiting the advantages inherent to xenotransplantation, namely the ability to reduce organ ischemic times by co-locating the donor and recipient.
View Article and Find Full Text PDFEarly Results of an Infant Model of Orthotopic Cardiac Xenotransplantation.
J Heart Lung Transplant
January 2025
Division of Cardiac Surgery, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA. Electronic address:
Objective: Genetically engineered porcine hearts may have an application for infants in need of a bridge to cardiac allotransplantation. The current animal model that resulted in 2 human applications has been validated in adult non-human primates only. We sought to create an infant animal model of life sustaining cardiac xenotransplantation to understand limitations specific to this age group.
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