Heart transplantation is a definitive treatment option for patients with end-stage heart failure. Medical and functional complications are common after this procedure, and rehabilitation is often needed postoperatively. Physiatrists caring for persons who have received a donor heart must appreciate the surgical background, the physiologic changes expected, as well as the potential medical complications for which they are at risk after heart transplantation. This review summarizes various topics in heart transplantation including the history of the procedure, exercise physiology and functional outcomes, postoperative medical therapy, medical complications, and special considerations for inpatient rehabilitation in this patient population.
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Impact of Heart Transplant Allocation Changes on Waitlist Mortality and Clinical Practice in Pediatric and Adult Patients With Congenital Heart Disease and Cardiomyopathy.
Circulation
January 2025
Division of Cardiology, Children's Hospital of Philadelphia and Department of Pediatrics (L.W., M.J.O., H.A., J.E., K.Y.L., C.W.-W., J.R., J.B.E.), University of Pennsylvania, Philadelphia.
Background: The United Network of Organ Sharing made changes to the priority for allocation of hearts for transplantation (HT) in 2016 for pediatric patients and 2018 for adult patients. Although recent work has evaluated the impact of the revised allocation systems on mechanical circulatory support practices and waitlist outcomes, there are limited data that focus more specifically on the impact of the allocation changes on patients with congenital heart disease (CHD) or cardiomyopathy and how these relationships might differ in pediatric and adult patients.
Methods: The United Network of Organ Sharing database was queried for pediatric (<18 years of age) and adult (18-50 years of age) patients with a CHD or cardiomyopathy diagnosis listed for HT.
Options for pediatric heart valve replacement.
Future Cardiol
January 2025
Department of Cardiovascular Surgery, Arkansas Children's Hospital, Little Rock, AR, USA.
Heart valve replacement is indicated for children with irreparable heart valve disease. These replacements come in a variety of forms including mechanical, xenograft tissue, allograft tissue, and autograft tissue valves. These options each have unique benefits and risks profiles.
View Article and Find Full Text PDFDelayed open-heart operation to remove migrated intracardiac inferior vena cava stents in a living donor liver transplantation recipient: a case report.
Nagoya J Med Sci
November 2024
School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Intracardiac migration of inferior vena cava (IVC) filter or stent is a rare but potentially fatal complication of endovascular venous device placement. There is no consensus whether migrated stents should be surgically removed by open cardiac surgery or retrieved by the percutaneous endovascular route and whether an intervention should be performed immediately or expectantly. Herein, we report a 39-year-old female who received emergent left lobe living donor liver transplantation (LDLT) owing to posthepatectomy liver failure.
View Article and Find Full Text PDFFifteen-year experience of direct bridge with venoarterial extracorporeal membrane oxygenation to heart transplantation.
JTCVS Open
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Thoracic and Cardiovascular Surgery Department, Sorbonne Université, APHP, Groupe Hospitalier Pitié-Salpétrière, Institute of Cardiology, Paris, France.
Objective: The study objective was to evaluate outcomes of patients directly bridged with venoarterial extracorporeal membrane oxygenation to heart transplantation.
Methods: A single-center retrospective study was performed on 1152 adult patients undergoing isolated cardiac transplantation between January 2007 and December 2021. Among these, patients bridged with an extracorporeal membrane oxygenation to transplantation (extracorporeal membrane oxygenation group, n = 317) were compared with standard cohorts of patients (no extracorporeal membrane oxygenation group, n = 835).
A propensity-matched analysis of cardiac operation in patients with and without cardiac amyloidosis.
JTCVS Open
December 2024
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.
Objective: There are limited data on the outcome of routine cardiac operations in patients with cardiac amyloidosis. This study studied the impact of amyloidosis on early and late results of cardiac operations.
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