Transplantation

Haemodynamics of Heart Failure With Preserved Ejection Fraction: A Clinical Perspective

Despite the burden of heart failure (HF) with preserved ejection fraction (HFpEF),1 its pathophysiological mechanisms remain controversial and are likely to be multifactorial.2,3,4 The lack of a comprehensive paradigm applicable to all patients suggests that haemodynamic derangements responsible for this disorder may be quite heterogeneous. As recently highlighted, haemodynamic features of HFpEF involve both cardiac and extra-cardiac mechanisms.

Chagas Heart Failure in Patients from Latin America

More than a century after its discovery, Chagas disease still is a major health problem in Latin America, with 5.7 million people in 21 countries being affected by it.1 Moreover, about 70 million people are at risk of acquiring the illness.1 Cases of Chagas disease are now found globally; there are more than 400,000 immigrants with this disease living in Europe (mainly in Spain, Italy and France) and the United States.2 The consequence of this is that the annual global (direct plus indirect) cost of the disease is in the region of US $7.2 b

Arrhythmias in the Heart Transplant Patient

Orthotopic heart transplantation (OHT) is the most effective long-term therapy for end-stage heart disease, with implanted left ventricular assist devices (‘destination therapy’) as an alternative for selected patients. The denervation of the transplanted heart with complete loss of autonomic nervous system modulation, the use of immunosuppressant drugs, as well as the risk of allograft rejection (AR) and vasculopathy, all change the incidence, prognosis and treatment of tachyarrhythmias and bradyarrhythmias, as well as the mechanisms of sudden cardiac death (SCD).

New test identifies heart transplant rejection earlier than biopsy

A new DNA blood test may reveal whether or not a heart transplant recipient will experience rejection from a donor organ.

The test can detect small differences in the circulating DNA of both the transplant donor and the recipient, gauging the likelihood of the transplanted organ surviving in its new environment.  The developers of the test believe it could potentially eliminate the need for invasive heart biopsies in the future – procedures that transplant recipients must undergo regularly to monitor organ rejection.

Cardiac Transplantation - Status in 2011

The field of heart transplantation has evolved tremendously since Alexis Carrel first explanted a canine heart and anastomosed it to the carotid artery and jugular vein of a recipient dog in 1905.1 In 1960, Norman Shumway and Richard Lower at Stanford described a technique for orthotopic canine heart transplantation and demonstrated adequate physiologic function of the denervated heart.2 Their work paved the way for the first successful human-to-human heart transplant by Dr Christiaan Barnard in South Africa in December 1967,3 followed cl

The Use of an Absorbable Microporous Polysaccharide Hemosphere Haemostat (AristaAH) in Ventricular Assist Device Implant and Cardiac Transplantation Procedures

The use of mechanical circulatory assist devices is rapidly expanding. Patients in advanced stages of heart failure are implanted with support devices, allowing them to regain a fairly normal level of activity. Presently, more then 3,500 patients live with a left ventricular assist device (LVAD). The numbers of patients supported with biventricular assist devices or total artificial hearts is much smaller. The implantation of the total artificial heart is a quite extensive surgical procedure.