Abstract:
:Postoperative tricuspid valve regurgitation is moderate to severe in 15% to 20% of heart transplant recipients despite use of the bicaval surgical technique. We hypothesized that the regurgitation might be partly due to increased tension on the donor right atrium. To study the right atrial distortion, we modified the standard bicaval anastomosis. Our technique involves augmenting the donor right atrial anterior wall with a flap of the recipient's right atrium, which is left attached in continuity with the anterior aspect of the inferior vena cava along 65% of its circumference. We measured tricuspid regurgitation, right atrial area, and right atrioventricular diameter in 7 consecutive patients who underwent orthotopic heart transplantation with the modified anastomosis. Tricuspid regurgitation was graded as follows: 1 = trace, <10%; 2 = mild, 10%-24%; 3 = moderate, 25%-50%; and 4 = severe, >50%. All patients were weaned from inotropic support within 1 week after transplantation with excellent ventricular function, no heart block, and 100% survival at 30 days. The median follow-up time was 173 days (44-358 days). Other median measurements included tricuspid valve regurgitation jet area, 0.30 cm(2) (0-1.90 cm(2)); right atrial area, 15.90 cm(2) (14.47-18.00 cm(2)); atrioventricular diameter, 2.70 cm (2.63-3.09 cm); and tricuspid regurgitation, 1.67% (0-12.42%). Mild regurgitation occurred in 1 recipient; in all others, it was trace. The modified inferior vena caval anastomosis is simple and safe. It eliminates moderate and severe tricuspid valve regurgitation without routine annuloplasty after orthotopic heart transplantation via the bicaval technique.
journal_name
Tex Heart Inst Jjournal_title
Texas Heart Institute journalauthors
Marelli D,Silvestry SC,Zwas D,Mather P,Rubin S,Dempsey AF,Stein L,Rodriguez E,Diehl JT,Feldman AMsubject
Has Abstractpub_date
2007-01-01 00:00:00pages
30-5issue
1eissn
0730-2347issn
1526-6702journal_volume
34pub_type
杂志文章abstract::The central question that faces coronary laser investigators is whether interaction between laser energy and target tissues can be controlled in a dynamic in vivo environment. In considering this question, the author reviews the in vitro and in vivo experiments that his center carried out before it began using laser a...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::We present the case of a 69-year-old man with a history of hypertension and a recent pelvic fracture who presented with acute chest pain, shortness of breath, and severe hypotension. The history of recent pelvic fracture and the clinical manifestations, including the sudden onset of acute respiratory distress, hypoten...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::Three groups of consecutive patients who had undergone primary elective coronary artery bypass operations were compared at 10 to 20 years of follow-up (mean, 13.6 years), in order to test the supposition that arterial conduits provide better long-term outcome than do the "standard" left internal mammary-to-left anteri...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were ...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:10.14503/THIJ-13-3191
更新日期:2014-04-01 00:00:00
abstract::We report the case of a 65-year-old man who presented with an infrarenal aortic aneurysm in association with a congenital right pelvic kidney vascularized by 2 aortic arteries, 1 of which arose from the aneurysmal aorta and the other from the common right iliac artery. Successful surgery consisted of excising the aneu...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章,评审
doi:
更新日期:1997-01-01 00:00:00
abstract::A 14-month-old boy with a structurally normal heart presented with signs of cardiac tamponade caused by purulent pericarditis. During his hospital stay, mitral and tricuspid valve endocarditis developed, and a ventricular septal abscess expanded despite appropriate, prolonged antibiotic therapy for methicillin-resista...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:10.14503/THIJ-13-3685
更新日期:2015-02-01 00:00:00
abstract::Because of physiologic R-R interval variability and arrhythmia, frame-mode acquisition of gated images may produce erroneous left ventricular volume curves, particularly in the diastolic filling phase. Eighteen patients in sinus rhythm underwent gated imaging in which both frame-mode and list-mode acquisitions were us...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract::Inferior vena cava filters are commonly used to prevent pulmonary embolism in patients who manifest deep vein thrombosis and recurrent pulmonary embolism despite anticoagulation, or in patients with contraindications to anticoagulation. We report the case of a 69-year-old man with a structurally normal heart who exper...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract::Interventional cardiologists have few data on which to base clinical decisions regarding optimal care for ST-segment-elevation myocardial infarction patients who are taking therapeutic chronic oral anticoagulation. We present what we believe to be the first reported case of emergency coronary angiography and primary p...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:10.14503/THIJ-13-3727
更新日期:2015-04-01 00:00:00
abstract::Mesenteric ischemia can be difficult to diagnose without a high degree of suspicion because it presents in a variety of ways. Visceral vascular collaterals between the fore- and midgut often provide protection against ischemia; however, the presence of anatomic variations, such as celiomesenteric trunk, can undermine ...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:10.14503/THIJ-16-6155
更新日期:2018-02-01 00:00:00
abstract::Glucose-6-phosphate dehydrogenase (G6PD) protects erythrocytes from oxidative stress and hemolysis; G6PD deficiency is the most prevalent enzymopathy. The United States military routinely performs tests to prevent exposing G6PD-deficient personnel to antimalarial drugs that might cause life-threatening hemolytic react...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章,多中心研究
doi:10.14503/THIJ-16-6052
更新日期:2018-06-01 00:00:00
abstract::We report a case of an 11-year-old girl who presented with a slowly enlarging mass in the right posterolateral chest wall. Computed tomography showed a soft-tissue mass 8.5 × 7.5 × 5.5 cm in size, arising from the right posterolateral 9th, 10th, and 11th intercostal spaces. Magnetic resonance imaging confirmed a vascu...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract::The clinical presentation of the bronchogenic cyst is variable, from respiratory distress at birth to late appearance of symptoms. In order to determine clinical features and treatments, we retrospectively studied the medical records and pathology reports of all patients with bronchogenic cysts (n = 22) referred to ou...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::This report describes an unusual case of subaortic stenosis in which hypertrophic obstructive cardiomyopathy was found in combination with both anomalous insertion of papillary muscle directly into the anterior mitral leaflet and "sawfish" systolic narrowing of the left anterior descending coronary artery. Definitive ...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::A successful cardiac transplant starts with the selection of an appropriate donor. Once consent to organ donation has been obtained, the donor should be managed aggressively in order to maintain optimal organ function. In the case of multi-organ donation, the heart is the first organ to be prepared, as well as the fir...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract::Doxorubicin, an anthracycline antibiotic commonly used as a chemotherapeutic agent for breast cancer, is well known to cause cardiotoxicity. We report the case of an active, otherwise healthy 57-year-old breast cancer survivor who, 17 years after chemotherapy, presented with symptoms of overt heart failure. She had no...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::The objective of this study was to determine the safety and feasibility of performing transendocardial electromechanical mapping and mesenchymal precursor stem cell injections after left ventricular assist device (LVAD) implantation in a sheep model of acute myocardial infarction. Six sheep were assigned to either an ...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract::The benefit of defibrillator therapy has been well established for patients with LV dysfunction (ejection fraction less than 35%), coronary artery disease, NSVT, and inducible and nonsuppressible ventricular tachycardia. Implantable cardioverter-defibrillator therapy is also indicated for all CHF patients in NYHA func...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::No data are available on the long-term outcome of coronary-coronary venous bypass grafting. We describe a case in which we successfully stented a discrete, critical stenosis of a coronary-coronary venous graft that had been placed 19 years earlier to minimize manipulation of a severely calcified ascending aorta. Coron...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::This study compares the medium-term results of De Vega, modified De Vega, and ring annuloplasty techniques for the correction of tricuspid insufficiency and investigates the risk factors for recurrent grades 3 and 4 tricuspid insufficiency after repair. In our clinic, 93 patients with functional tricuspid insufficienc...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract::Influenza causes cardiac and pulmonary complications that can lead to death. Its effect on the conduction system, first described a century ago, has long been thought to be fairly benign. We report 2 cases of high-grade atrioventricular block associated with acute influenza infection. Both patients-a 50-year-old woman...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:10.14503/THIJ-18-6658
更新日期:2020-06-01 00:00:00
abstract::Pulmonary hypertension associated with pediatric congenital heart defects is a major cause of postoperative morbidity and death. Sildenafil has been combined with inhaled nitric oxide to treat pulmonary hypertension. We retrospectively studied the pre- and postoperative effects of oral sildenafil as monotherapy in chi...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract::The surface electrocardiogram can be simply described as the P, QRS, and T (and U) waves, together with PR and ST segments. However, it is actually the summation of the action potential from the sinoatrial node, the atria, the atrioventricular node, the His-Purkinje system, and the ventricles. Although the action pote...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章,评审
doi:
更新日期:1994-01-01 00:00:00
abstract::We sought to compare outcomes in patients > or = 60 years of age with those of their younger counterparts who underwent ventricular assist device implantation intended as a bridge to cardiac transplantation and also to identify retrospectively additional pre- and postoperative factors that might portend adverse outcom...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2009-01-01 00:00:00
abstract::Mycotic aneurysm formation is a rare and potentially fatal sequela of bacteremia. We present the cases of 2 octogenarians who had surgically confirmed mycotic aneurysms that involved the ascending aorta, with contained rupture (pseudoaneurysm). Neither patient had evidence of valvular endocarditis. Patient 1, an 82-ye...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract::We present a series of 4 patients in whom mechanical trauma was identified as a factor in the development of late complications after AneuRx Stent Graft placement for repair of abdominal aortic aneurysms. In all 4 patients, Type I or III endoleaks (and pseudoaneurysms in 2 patients) were discovered several months afte...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::The glutaraldehyde-preserved stented porcine xenograft valve has been durable in adult patients with a low incidence of valve-related complications. In children, however, early degeneration and calcification of this valve is now being reported. The etiology of the early degeneration is still unclear but may be related...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:1982-03-01 00:00:00
abstract::The levels of brain natriuretic peptide (BNP) and monocyte chemoattractant protein-1 (MCP-1) are known to be increased in the sera of subjects with heart failure. Existing models do not account for the biomass of thrombus that occurs in patients undergoing myocardial infarction. In this study, we compared the expressi...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract::To investigate whether transcatheter device closure of patent ductus arteriosus (PDA) is safe in children with pulmonary artery hypertension, we retrospectively analyzed our experience with 33 patients who underwent the procedure from January 2000 through August 2015. Pulmonary artery hypertension was defined as a pul...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:10.14503/THIJ-19-6982
更新日期:2020-08-01 00:00:00
abstract::Few orthotopic heart transplantations have been performed in patients infected with the human immunodeficiency virus since the first such case was reported in 2001. Since that time, advances in highly active antiretroviral therapy have resulted in potent and durable suppression of the causative human immunodeficiency ...
journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:10.14503/THIJ-14-4746
更新日期:2016-02-01 00:00:00