ABSTRACT
Heart transplantation remains the treatment of choice in selected patients with severe heart failure (HF) despite optimal medical therapy. Since long-term survival after HTX is improving, there is a growing need for evidence-based strategies that reduce long-term mortality resulting from both immunological and non-immunological risk. This manuscript summarizes recommendations for treatment of transplant vasculopathy, malignancy after transplantation, and prevention of corticosteroid induced bone disease. Based on actual understanding of cardiovascular risk factors in the population, preservation of renal function, prevention and treatment of hyperlipidemia and diabetes, as well as blood pressure control play an important role in the long-term follow-up after heart transplantation.
Subject(s)
Cardiovascular Agents/therapeutic use , Heart Transplantation/rehabilitation , Immunosuppressive Agents/therapeutic use , Practice Guidelines as Topic , Contraindications , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/prevention & control , Graft Survival , Heart Failure/therapy , Heart Transplantation/mortality , Heart Transplantation/standards , HumansABSTRACT
With the advent of new technologies, experience with long-term mechanical circulatory support (MCS) is rapidly growing. Candidates to MCS are selected based on concepts, strategies and classifications that are specific to this indication. As results drastically improve, supported by stronger scientific evidence, the trend is towards earlier implantation. An adequate pre-implant follow-up is mandatory in order to avoid missing the best window of opportunity for implantation. While on chronic support, the hemodynamic profile of patients with continuous-flow ventricular assist devices is unique and remarkably influenced by the hydration status. Optimal management of these patients from the pre-implant phase to the long-term support phase requires a multidisciplinary approach that is similar to that already long validated for organ transplantation.
Subject(s)
Assisted Circulation/trends , Cardiology/trends , Assisted Circulation/instrumentation , Assisted Circulation/legislation & jurisprudence , Assisted Circulation/methods , Cardiology/instrumentation , Cardiology/legislation & jurisprudence , Cardiology/methods , Coronary Circulation/physiology , Heart Diseases/therapy , Heart-Assist Devices , Humans , Long-Term Care , Models, Biological , Practice Guidelines as Topic , Time FactorsABSTRACT
The present review provides a selected choice of clinical research in the field of interventional cardiology, heart failure and cardiac imaging. We also focused on the new guidelines published by the European society of cardiology in 2012.
Subject(s)
Cardiology/trends , Administration, Oral , Anticoagulants/administration & dosage , Cardiac Imaging Techniques/methods , Cardiac Imaging Techniques/trends , Cardiac Surgical Procedures/methods , Cardiac Surgical Procedures/trends , Cardiology/methods , Drug Dosage Calculations , Heart Failure/therapy , Humans , Myocardial Infarction/classification , Myocardial Infarction/diagnosis , Stents , Terminology as TopicABSTRACT
Heart transplantation (HTx) started in 1987 at two university hospitals (CHUV, HUG) in the western part of Switzerland, with 223 HTx performed at the CHUV until December 2010. Between 1987 and 2003, 106 HTx were realized at the HUG resulting in a total of 329 HTx in the western part of Switzerland. After the relocation of organ transplantation activity in the western part of Switzerland in 2003, the surgical part and the early postoperative care of HTx remained limited to the CHUV. However, every other HTx activity are pursued at the two university hospitals (CHUV, HUG). This article summarizes the actual protocols for selection and pre-transplant follow-up of HTx candidates in the western part of Switzerland, permitting a uniform structure of pretransplant follow-up in the western part of Switzerland.