The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery:third report

OBJECTIVES: In the third report of the European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery, outcomes of patients receiving mechanical circulatory support are reviewed in relation to implant era. METHODS: Procedures in adult patients (January 2011-June 2020) were included. Patients from centres with 3 months). Risk factors for death were explored using univariable Cox regression with a stepwise time-varying hazard ratio (3 months). RESULTS: In total, 4834 procedures in 4486 individual patients (72 hospitals) were included, with a median follow-up of 1.1 (interquartile range: 0.3-2.6) years. The annual number of implants (range: 346-600) did not significantly change (P = 0.41). Both Interagency Registry for Mechanically Assisted Circulatory Support class (classes 4-7: 23, 25 and 33%; P 3 months: 0.45). Bilirubin and creatinine levels were significant risk factors in the early phase but not in the late phase after the implant. CONCLUSIONS: In its 10 years of existence, EUROMACS has become a point of reference enabling benchmarking and outcome monitoring. Patient characteristics and outcomes changed between implant eras. In addition, both occurrence of outcomes and risk factor weights are time dependent

Aortic root infection destroying the left fibrous trigone

PubMed ID: 15902839[No abstract available

Anesthesia for Ventricular Assist Device Placement: Experience From a Single Center

9th Congress of the Turkish-Transplantation-Centers-Coordination-Association (TTCCA) -- SEP 26-29, 2012 -- Bursa, TURKEYWOS: 000318457000041PubMed ID: 23622609Background. Circulatory support with ventricular assist systems has become a treatment alternative for patients with end-stage heart failure owing to the donor shortage. In this report, we have presented our institution's clinical experience in the anesthetic management of ventricular assist device (VAD) implantation. Methods. Between April 2007 and August 2012, VAD implantation was performed in 84 adult patients with end-stage heart failure. The group included 75 male and 9 female patients of overall mean age, 47.6 +/- 13.4 years. Our retrospective review analyzed elements of perioperative anesthetic care, including preoperative characteristics, general anesthetic care, and blood product usage. Results. The indications for VAD implantation were dilated (n = 59; 70%) or ischemic cardiomyopathy (n = 25; 30%). An intra-aortic balloon pump had been placed in 16 patients. We monitored invasive arterial and central venous pressures as well as intraoperative transesophageal echocardiography. Etomidate was used as the induction agent in 79 of 84 patients (average dose, 18.75 +/- 1.40 mg). Intraoperative fentanyl dose was 939.69 +/- 212.44 mu g. Anesthesia was maintained with sevoflurane (n = 55) or desflurane (n = 29). Dopamine, dobutamine, epinephrine, norepinephrine, and levosimendan were used in 74, 79, 60, 14, and 32 patients, respectively. Inhaled nitric oxide was administered to 38 subjects (45%). The amounts of perioperative blood, fresh frozen plasma, and thrombocyte suspension transfusions were 3.96 +/- 2.78, 1.91 +/- 1.21, 1.80 +/- 2.48 u, respectively. On average, patients were extubated 13 hours after arrival in the intensive care unit and discharged therefrom on day 8. Thirty-one patients were successfully bridged to heart transplantation. While 27 patients (32%) died during the follow-up period, 26 are still living on VAD support. Conclusion. Among patients undergoing VAD implantation, the anesthesiologist should become familiar with the device and consider the severity of cardiac and other end-organ dysfunction.Turkish Transplantat Ctr Coordinat Assoc (TTCCA

The Outcomes of VAD Implantation in Ege University: The Largest Experience of Turkey

35th Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation -- APR 15-18, 2015 -- Nice, FRANCEWOS: 000353251500841Int Soc Heart & Lung Transplanta

Asymptomatic cytomegalovirus retinitis after cardiac transplantation

WOS: 000186459700013PubMed ID: 14573981Purpose: To determine the prevalence and the risk factors of cytomegalovirus (CMV) retinitis after cardiac transplantation in visually asymptomatic patients. Methods: Ophthalmoscopic examinations including fundus fluorescein angiography were performed in asymptomatic patients who had cardiac transplantation at Ege University Hospital between April 1998 and June 2002 to screen for evidence of diagnostic CMV retinitis lesions to determine the prevalence in this population. Results: Thirteen patients (aged 40 +/- 12.6) who had cardiac transplantation underwent ophthalmoscopic examination 2-50 months (23.5 +/- 16.2 months; mean +/- SD) after transplantation. All recipients had positive serology to CMV before transplantation. During the study period, 3 patients developed asymptomatic CMV reactivation. One patient developed CMV disease (pneumonia). All of the patients were visually asymptomatic during the study period. Two patients (15%) had a history of diabetes mellitus and chronic severe arterial hypertension. Seven recipients (53%) had been heavy cigarette smokers and 3 patients (23%) had hyperlipidemia. Two (15%) of 13 patients with arterial hypertension and diabetes had evidence of asymptomatic active CMV retinitis. These patients were treated with intravenous ganciclovir. Conclusions: Active cytomegalovirus retinitis lesions were found in 2 (15%) of 13 cardiac transplantation patients who had no visual symptoms. We think that the patients with systemic microvascular risk factors such as diabetes, hypertension and smoking should be screened closely for the development of CMV retinitis after cardiac transplantation even if the patients have no visual symptoms. Copyright (C) 2003 S. Karger AG, Basel