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Transplant-associated thrombotic microangiopathy:a rare but deadly complication post orthotopic heart transplantation

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Journal of Geriatric Cardiology 2022年第6期19卷 485-486页

作者： Jose Ruiz-Morales Maedeh Ganji rohan goswami Division of Advanced Heart Failure&Transplant Cardiology Mayo ClinicJacksonvilleFloridaUSA Cardiology Department University of FloridaJacksonvilleFloridaUSA

Thrombotic microangiopathy(TMA)is potentially life-threatening condition caused by small-vessel microthrombi and is associated with schistocyte formation,low platelets and end-organ damage that may not be reversible.[1,2]As a life-threatening condition,TMA recognition in hospitalized patients after organ transplantation is key to improving ***-associated TMA(TATMA)can occur after both solid organ or hematopoietic stem cell transplantation and often mimics other disease processes such as thrombotic throm-bocytopenic purpura(TTP)with similar constellation of symptoms during *** present a rare case of a patient with TATMA after orthotopic heart transplantation.

关键词： thrombotic microangiopathy orthotopic

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One-year survival in recipients older than 50 bridged to heart transplant with Impella 5.5 via axillary approach

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Journal of Geriatric Cardiology 2023年第5期20卷 319-329页

作者： Smit Paghdar Smruti Desai Ji-Min Jang Jose Ruiz Sharan Malkani Parag Patel Daniel S Yip Juan C Leoni Jose Nativi Basar Sareyyupoglu Kevin Landolfo Si Pham rohan M goswami Division of Heart Failure and Transplant Mayo Clinic in FloridaUSA Department of Cardiothoracic Surgery Mayo Clinic in FloridaUSA

BACKGROUND Optimizing patients with advanced heart failure before orthotopic heart transplantation(OHT), especially in patients greater than 50 years old, is imperative to achieving successful post-transplant outcomes. Complications are well-described for patients bridged to transplant(BTT) with durable left ventricular assist device(LVAD) support. Given the lack of data available in older recipients after the recent increase in mechanical support use, we felt it crucial to report our center’s one-year outcomes in older recipients after heart transplantation with percutaneously placed Impella 5.5 as a *** Forty-nine OHT patients were supported with the Impella 5.5 intended as a bridge between December 2019 and October 2022 at Mayo Clinic in Florida. Data were extracted from the electronic health record at baseline and during their transplant episode of care after Institutional Review Boards approval as exempt for retrospective data *** Thirty-eight patients aged 50 or older were supported with Impella 5.5 as BTT. Ten patients underwent heart and kidney transplantation within this cohort. The median age at OHT was 63(58–68) years, with 32 male(84%) and six female patients(16%). Etiology was divided into ischemic(63%) and non-ischemic cardiomyopathy(37%). The baseline median ejection fraction was 19%(15–24). Most patients were in blood group O(60%), and 50% were diabetic. The average duration of support was 27 days(range 6–94). The median duration of follow-up is 488 days(185–693). For patients that have reached the 1-year follow-up timeframe(22 of 38, 58%), the 1-year post-transplant survival is 95%.CONCLUSION Our single-center data provides awareness for using the Impella 5.5 percutaneously placed axillary support device in older heart failure patients in cardiogenic shock as a bridge to transplantation. One-year survival outcomes after heart transplantation are excellent despite the older recipient’s age and prolonged pre-transplant support.

关键词： One approval transplant

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维普期刊数据库

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Migration of intra-aortic balloon pump causing obstruction of the superior mesenteric artery

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Journal of Geriatric Cardiology 2022年第11期19卷 928-929页

作者： Sharan Malkani Jose Ruiz Smruti Desai Smit Paghdar Parag C.Patel Juan Carlos Leoni Moreno Melissa Lyle Maedeh Ganji Daniel Yip rohan M.goswami Division of Transplant Cardiology Mayo ClinicJacksonvilleFLUSA Division of Cardiology First Coast Heart&VascularJacksonvilleFLUSA

Axillary intra-aortic balloon pump(IABP)used has increased in the recent few years after UNOs allocation system ***’s design and counterpulsation mechanism is highly regarded for its safety profile,simplicity and relative ease in management and ***,despite continuous innovative efforts,the potential for complications still *** Benchmark registry is widely regarded as the tool for monitoring the evolving practice of *** most common complications reported are balloon perforation,bleeding,migration,limb *** continuous innovative efforts,the potential for complications still exists.

关键词： balloon IABP pump

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