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1.
Mini Rev Med Chem ; 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32048968

RESUMO

Traditional cancer treatment includes surgery, chemotherapy, radiotherapy and immunotherapy that are beneficially clinically, but are associated with drawbacks such as drug resistance and side effects. In quest of better treatment many new molecular targets have been introduced in the last few decades. Finding new molecular mechanisms encourages researchers to discover new anticancer agents. Exploring the mechanism of action also facilitates both anticipation of potential resistance mechanisms and optimization of rational combination therapies. The write up describes the leading molecular mechanisms for cancer therapy, including mTOR, tyrosine Wee1 kinase (WEE1), janus kinases, PI3K/mTOR signaling pathway, serine/threonine protein kinase AKT, checkpoint kinase 1 (Chk1), maternal embryonic leucine-zipper kinase (MELK), DNA methyltransferase I (DNMT1), poly (ADP-ribose) polymerase (PARP)-1/-2, sphingosine kinase-2 (SK2), pan-FGFR, inhibitor of apoptosis (IAP), murine double minute 2 (MDM2), Bcl-2 family protein and reactive oxygen species 1 (ROS1). Additionally, the manuscript reviews the anticancer drugs currently under clinical trials.

2.
Med Biol Eng Comput ; 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31897798

RESUMO

Cardiologists can acquire important information related to patients' cardiac health using carotid artery stiffness, its lumen diameter (LD), and its carotid intima-media thickness (cIMT). The sonographers primarily concern about the location of the artery in B-mode ultrasound images. Localization using manual methods is tedious and time-consuming and also may lead to some errors. On the other hand, automated approaches are more objective and can provide the localization of the artery at near real time. Above arterial parameters may be determined after localization of the artery in real time.A novel method of localization of common carotid artery (CCA) transverse section is presented in this work. The method is known as fast region convolutional neural network (FRCNN)-based localization method and is designed using a stack of three layers viz. convolutional layers, fully connected layers, and pooling layers. These organized layers constitute a region proposal network (RPN) and an object class detection network (OCDN). We obtain an outcome as a bounding box along with a score of prediction around the cross-section of the CCA.B-mode ultrasound image database of CCA is split into training and testing set, to accomplish this, three partition methods K = 2, 5, and 10 are used in our work. The training is extended for 30, 200, and 2000 epochs in order to achieve fine-tuned features from the convolutional neural network. After 2000 epochs, we obtain 95% validation accuracy; however, mean of the accuracies up to 2000 epochs is 89.36% for K = 10 partitions protocol (training 90%, testing 10%). Generated CNN model is tested on a different dataset of 433 images and the acquired accuracy is 87.99%. Thus, the proposed method including an advanced deep learning technique demonstrates promising localization for carotid artery transverse section. Graphical abstract.

5.
Circ Heart Fail ; 12(10): e006191, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31610725

RESUMO

BACKGROUND: Assessment of left ventricular (LV) recovery under continuous-flow LV assist device therapy is hampered by concomitant pump support. We describe derivation of noninvasive pressure-volume loops in continuous-flow LV assist device patients and demonstrate an application in the assessment of recovery. METHODS AND RESULTS: Using pump controller parameters and noninvasive arterial pressure waveforms, central aortic pressure, outflow conduit pressure gradient, and instantaneous LV pressure were calculated. Instantaneous LV volumes were calculated from echocardiographic LV end-diastolic volume accounting for the integral of pump flow with respect to time and aortic ejection volume derived from the pump speed waveform. Pressure-volume loops were derived during pump speed adjustment and following bolus intravenous milrinone to assess changes in loading conditions and contractility, respectively. Fourteen patients were studied. Baseline noninvasive LV end-diastolic pressure correlated with invasive pulmonary arterial wedge pressure (r2=0.57, root mean square error 5.0 mm Hg, P=0.003). Measured noninvasively, milrinone significantly increased LV ejection fraction (40.3±13.6% versus 36.8±14.2%, P<0.0001), maximum dP/dt (623±126 versus 555±122 mm Hg/s, P=0.006), and end-systolic elastance (1.03±0.57 versus 0.89±0.38 mm Hg/mL, P=0.008), consistent with its expected inotropic effect. Milrinone reduced myocardial oxygen consumption (0.15±0.06 versus 0.16±0.07 mL/beat, P=0.003) and improved myocardial efficiency (43.7±14.0% versus 41.2±15.5%, P=0.001). Reduced pump speed caused increased LV end-diastolic volume (190±80 versus 165±71 mL, P<0.0001) and LV end-diastolic pressure (14.3±10.2 versus 9.9±9.3 mm Hg, P=0.024), consistent with a predictable increase in preload. There was increased myocardial oxygen consumption (0.16±0.07 versus 0.14±0.06 mL O2/beat, P<0.0001) despite unchanged stroke work (P=0.24), reflecting decreased myocardial efficiency (39.2±12.7% versus 45.2±17.0%, P=0.003). CONCLUSIONS: Pressure-volume loops are able to be derived noninvasively in patients with the HeartWare HVAD and can detect induced changes in load and contractility.

6.
J Org Chem ; 84(16): 10237-10256, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31331169

RESUMO

A new family of adj-dicarbaporphyrinoids has been prepared using the "2 + 2" MacDonald methodology. Dibutylboron triflate catalyzed condensation of 3-iodo-4-methoxybenzaldehyde with an indene enamine afforded an iodofulvene aldehyde, and a related dimethoxyfulvene was similarly prepared in two steps from 2,4-dimethoxybenzaldehyde. Following protection as the corresponding dimethyl acetals, the iodofulvenes were metalated with Bu3MgLi at -100 °C and reacted with dimethylformamide to give the required fulvene dialdehyde intermediates. Acid-catalyzed condensation with three different dipyrrylmethanes afforded a series of benzo-23-carbabenziporphyrins in 52-70% yields. The proton nuclear magnetic resonance spectra for these adj-dicarbaporphyrinoids indicate that these macrocycles are slightly diatropic. Monoprotonation afforded cationic species with slightly larger aromatic ring currents, and under strongly acidic conditions, C-protonated dications were generated with substantial diatropic properties. The aromatic character of these structures was supported by nucleus-independent chemical shifts and anisotropy of induced current density calculations. The computational results indicate that the dications favor 23-atom 22π electron delocalization pathways. The benzo-23-carbabenziporphyrins were selectively oxidized with silver(I) acetate in dichloromethane-methanol to give stable nonaromatic structures with two additional methoxy substituents connected to sp3 hybridized bridging carbons. The intriguing reactivity and unique spectroscopic properties of benzo-23-carbabenziporphyrins make these novel structures promising candidates for further investigations.

7.
J Cardiothorac Vasc Anesth ; 33(10): 2647-2651, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31320261

RESUMO

OBJECTIVES: Increased utilization and highly variable costs seen with percutaneous mitral valve edge-to-edge repair have made cost cutting strategies of significant interest. Mitral regurgitation etiology, the number of devices used, and experience all play a role in variability. Currently a paucity of data exists in predicting the number of devices. Any associations found between echocardiography parameters and the number of devices used could help with pre-procedure planning and device placement strategies, ultimately reducing variability and costs. DESIGN: In this retrospective analysis the authors evaluated the ability of established and novel three-dimensional (3D) mitral regurgitation measures, namely 3D vena contracta area and vena contracta length, to predict the number of devices used. Other factors evaluated include mitral valve area and ejection fraction. All factors were compared using the Mann Whitney rank sum tests. PARTICIPANTS: Patients over 18 years old undergoing the MitraClip procedure. SETTING: Catheterization Laboratory. MAIN RESULTS: No relationship was found between 3D parameters and the number of devices used, but mitral valve area was strongly associated with the use of multiple devices. CONCLUSION: The 3D parameters of interest were not associated with the use of multiple devices, but the mitral valve area was associated. Further studies are needed to determine if this relationship is predictive.

8.
J Cytol ; 36(2): 111-115, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30992647

RESUMO

Background: The term oral potentially malignant disorder (OPMD) was recommended to refer to precancer as it conveys that not all disorders described under this term may transform into cancer. Oral squamous cell carcinoma (OSCC) arises through an accumulation of genetic alterations, deoxy ribonucleic acid (DNA) changes, and epigenetic alterations. Thus, a simple yet a sensitive and specific test for early diagnosis is the need of an hour. The micronuclei (MN) assay in exfoliated epithelial cells is potentially an excellent biomarker to detect chromosome loss or malfunction of mitotic spindle. Aim of the Study: To compare the frequency of MN in exfoliated cells from oral mucosa exposed to genotoxic agents using different staining procedures and to observe the incidence of micronucleus in potentially malignant and malignant lesions. Materials and Methods: The study was undertaken to observe the cytogenetic damage in the exfoliated buccal cells of 75 cases of tobacco-related PMDs, OSCC and control subjects (25 cases from each group) and were evaluated with nonspecific May-Grünwald Giemsa stain and DNA-specific Feulgen stain. The results were statistically determined using SPSS version 17.0. Results: Correlation analyses in the present study depicted that MN frequency was significantly more in oral squamous cell carcinoma than OPMDs and normal group (P < 0.05). Giemsa-stained slides correlated significantly with karyorrhexis, karyolysis, condensed chromatin, and binucleates, whereas no such correlations were found with DNA-specific stains. Conclusion: Malignant transformation is accompanied by loss of cell capacity to evolve to death in situations of DNA damage. These findings indicate that nuclear anomalies may be misinterpreted as MN with nonspecific DNA stains and lead to false-positive results in studies with cells of epithelial origin.

10.
ASAIO J ; 65(5): 489-494, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30762587

RESUMO

We evaluated mean, peak, and instantaneous pressure gradients across the outflow conduit in a pulsatile mock circulation loop which incorporated Heartware HVADs for left ventricular (LV) and right ventricular (RV) support. Steady-state 50 Hz measurements of left ventricular assist device (LVAD) flow (Q) and pressures within the proximal and distal outflow conduit were obtained at varying pump speed, LV contractility, hematocrit (HCT), heart rate (HR), and conduit diameter and length. Experiments were conducted using polyvinyl chloride (PVC) tubing and results confirmed in HVAD Gelweave conduit. Conduit diameter was negatively and nonlinearly associated with mean and peak gradient in both the PVC and HVAD conduits. There were no significant differences between the PVC and HVAD conduits in terms of mean Q, systolic dQ/dt, mean conduit gradient, or peak gradient. Across the 10 mm HVAD conduit, mean gradient correlated linearly with mean Q, systolic dQ/dt, HCT, and conduit length (r = 0.91), whereas peak gradient correlated with mean Q, systolic dQ/dt, and conduit length (r = 0.93). A nonlinear model to determine instantaneous gradient was highly predictive (r = 0.83) across a range of pump and circulatory conditions. In summary, hemodynamically significant pressure gradients are observed across the LVAD outflow conduit under physiologic conditions, which may result in diminished pump flow.

11.
J Cardiothorac Vasc Anesth ; 33(2): 290-301, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30146466

RESUMO

In 2017 the American College of Cardiology issued an Expert Consensus Decision Pathway dedicated specifically to the management of bleeding in patients on anticoagulants. The consensus document is both timely and important as indications for more novel anticoagulants expand rapidly. The document reviews in detail recommendations for interruption, management and re-initiation of anticoagulation in bleeding scenarios. Numerous points within the document are relevant to perioperative physicians managing patients on anticoagulation with either bleeding complications or undergoing surgical procedures. The intent of this narrative review is to highlight the salient points within the expert consensus for perioperative physicians.


Assuntos
Anticoagulantes/administração & dosagem , Cardiologia/normas , Consenso , Tomada de Decisões , Hemorragia/terapia , Assistência Perioperatória/métodos , Médicos , Administração Oral , Hemorragia/induzido quimicamente , Humanos , Tromboembolia/prevenção & controle , Terapia Trombolítica/normas , Estados Unidos
12.
J Cardiothorac Vasc Anesth ; 33(2): 274-289, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30149983

RESUMO

Chronic mitral regurgitation (MR) is the most prevalent valvular lesion in the adult US population. Appropriate patient selection for mitral intervention and selection of the appropriate interventional strategy and optimal periprocedural management rely on thorough clinical evaluation, accurate echocardiographic input, and in-depth understanding of chronic MR pathophysiology on the part of the cardiac anesthesiologist. The recently published Expert Consensus Decision Pathway on the management of MR was designed to provide tools to help the clinician with broad clinical decision-making, including patient referral, and the present review focuses and elaborates on the key aspects relevant to the cardiac anesthesiologist in the peri-interventional setting.


Assuntos
Anestesiologia , Cardiologia , Consenso , Tomada de Decisões , Gerenciamento Clínico , Implante de Prótese de Valva Cardíaca/normas , Insuficiência da Valva Mitral/cirurgia , Cateterismo Cardíaco , Humanos
13.
Heart Lung Circ ; 28(2): 289-294, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29150159

RESUMO

BACKGROUND: Reliable markers of early disease are needed in pulmonary arterial hypertension (PAH). As measures of the contribution of abnormal vascular compliance to overall vascular resistance, resting and exercise pulmonary capacitance-defined as the stroke volume divided by the change in pulmonary pulse pressure-may be sensitive markers of early disease. METHODS: We examined all patients in our pulmonary hypertension database with idiopathic PAH, who had undergone rest and exercise right heart catheterisation in one sitting. Standard haemodynamic measurements were obtained, including pulmonary capacitance. These results were compared to age- and sex-matched normal controls. RESULTS: We analysed 27 right heart catheterisations in idiopathic PAH patients and 23 in controls. Mean pulmonary artery pressure (MPAP), mean pulmonary capillary wedge pressure (mPCWP), pulmonary vascular resistance (PVR) and right ventricular stroke work index (RVSWI) were significantly higher at baseline in diseased patients, while Cardiac Index (CI) and pulmonary capacitance were significantly lower. MPAP, mPCWP, cardiac index and RVSWI increased significantly in both groups with exercise. Pulmonary capacitance decreased significantly in both groups. Pulmonary vascular resistance decreased with exercise in the control group only. Capacitance and PVR were inversely correlated at rest (time-constant of 0.79s) and with exercise (time-constant of 0.56s). The receiver operating characteristic (ROC) curve for capacitance as a diagnostic marker demonstrated an AUC of 0.96 at rest and 0.95 with exercise. CONCLUSIONS: In idiopathic pulmonary arterial hypertension (IPAH) there is a reduction in pulmonary capacitance at baseline and left-shift of the inverse capacitance-PVR relationship with exercise. Both resting and exercise pulmonary capacitance have potential as diagnostic markers in early disease.


Assuntos
Exercício/fisiologia , Hipertensão Pulmonar/diagnóstico , Pressão Propulsora Pulmonar/fisiologia , Descanso/fisiologia , Resistência Vascular/fisiologia , Função Ventricular Direita/fisiologia , Cateterismo Cardíaco , Feminino , Humanos , Hipertensão Pulmonar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Curva ROC
14.
Mol Biol Rep ; 45(5): 1357-1365, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30105550

RESUMO

The present study was designed to investigate the protective effect of ferulic acid (FA) against isoproterenol (ISO)-induced cardiac toxicity in rats. Isoproterenol challenged in a dose of 85 mg/kg body weight (b.w.) subcutaneously for two consecutive days in the experimental group resulted in acute cardiac toxicity as evidenced by changes in electrocardiogram (ECG) pattern and marked elevation of serum cardiac enzymes viz aspartate aminotransferase (AST), alanine transaminase (ALT), creatinine kinase (CK-MB) and lactate dehydrogenase (LDH) also increases inflammatory cytokines. Moreover, acute toxicity effect was exhibited by disturbance in the antioxidant system as decrease in activities of superoxide dismutase (SOD) and glutathione (GSH) with the rise in activities of malondialdehyde (MDA) and nitric oxide (NO). Pre-treatment with FA at the increasing dose of (10, 20 and 40 mg/kg b.w.) orally for 28 consecutive days followed by isoproterenol injection for 2 days significantly attenuated changes in serum cardiac enzymes. Furthermore, histopathological evaluation confirmed the restoration of cellular architecture in FA pretreated rats. The cardioprotective effect of FA was comparable with standard drug treatment metoprolol. Taken together, FA demonstrated cardioprotective effect against ISO-induced cardiac toxicity by normalization of serum cardiac biomarkers, alleviating oxidative stress and augmenting endogenous antioxidant system.


Assuntos
Cardiotoxicidade/prevenção & controle , Ácidos Cumáricos/farmacologia , Isoproterenol/toxicidade , Alanina Transaminase/metabolismo , Animais , Aspartato Aminotransferases/metabolismo , Biomarcadores/sangue , Biomarcadores/metabolismo , Cardiotônicos/farmacologia , Cardiotoxicidade/metabolismo , Creatina Quinase Forma MB/metabolismo , Glutationa/metabolismo , Coração/efeitos dos fármacos , L-Lactato Desidrogenase/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/patologia , Miocárdio/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Superóxido Dismutase/metabolismo
15.
ESC Heart Fail ; 5(4): 695-702, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29573567

RESUMO

AIMS: Both ventricular assist device (VAD) and pulmonary vasodilator therapy have been shown in uncontrolled studies to improve pulmonary hypertension secondary to advanced left heart failure (Group 2 PH). This study aimed to compare haemodynamic benefits and survival in patients with fixed Group 2 PH treated with continuous-flow VAD to intensive medical therapy. METHODS AND RESULTS: Ninety-five patients listed for heart transplantation with sequential right heart catheters were studied, 24 patients having fixed Group 2 PH (as defined by cardiac index < 2.8 L/min/m2 , pulmonary capillary wedge pressure > 15 mmHg, and transpulmonary gradient ≥ 15 mmHg or pulmonary vascular resistance > 3.0 WU, unresponsive to vasodilator challenge). Ten patients received VAD therapy, and 14 patients received standard heart failure therapy with or without sildenafil, nitrates, or endothelin receptor antagonists. At repeat right heart catheterization, patients treated with VAD therapy demonstrated significant improvement in both transpulmonary gradient (19 vs. 12 mmHg, P = 0.046) and pulmonary vascular resistance (6.5 vs. 2.9 WU, P = 0.003) compared with baseline, while those treated with medical therapy did not (20.9 vs. 20.3 mmHg and 6.5 vs. 6.4 WU, P = NS for both). Patients who received VAD therapy were significantly more likely to achieve normalized transpulmonary gradient (8/10 vs. 4/14, P = 0.013) and were more likely to be listed for orthotopic heart transplantation (7/10 vs. 4/14, P < 0.05). There were no significant differences between groups in terms of all-cause mortality. CONCLUSIONS: Continuous-flow VAD therapy more effectively reverses fixed Group 2 PH compared with medical therapy alone and may allow a higher rate of listing for orthotopic heart transplantation.


Assuntos
Cateterismo Cardíaco/métodos , Insuficiência Cardíaca/complicações , Coração Auxiliar , Hipertensão Pulmonar/terapia , Artéria Pulmonar/fisiopatologia , Resistência Vascular/fisiologia , Vasodilatadores/uso terapêutico , Feminino , Seguimentos , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/terapia , Humanos , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pressão Propulsora Pulmonar/fisiologia , Estudos Retrospectivos , Volume Sistólico , Resultado do Tratamento
16.
J Cardiothorac Vasc Anesth ; 32(1): 467-477, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28967624

RESUMO

Hypertrophic cardiomyopathy is an increasingly recognized clinical disease that carries perioperative risk. Patients may or may not carry a preoperative diagnosis, but provocable left ventricular outflow tract gradients place them at risk for hemodynamic compromise under surgical conditions. Early recognition of obstructive patterns and rapid management alterations in the face of instability are imperative for the treatment of these patients. This review focuses on the diagnostic criteria, risk factors, and management strategies for the perioperative hypertrophic cardiomyopathy patient. Finally, novel diagnostic modalities are discussed.


Assuntos
Cardiomiopatia Hipertrófica/terapia , Obstrução do Fluxo Ventricular Externo/terapia , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Cardiomiopatia Hipertrófica/etiologia , Ecocardiografia Transesofagiana , Testes Genéticos , Humanos , Assistência Perioperatória , Sístole , Obstrução do Fluxo Ventricular Externo/diagnóstico por imagem , Obstrução do Fluxo Ventricular Externo/etiologia
17.
Anticancer Agents Med Chem ; 18(4): 597-609, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29173186

RESUMO

BACKGROUND: Liposomal doxorubicin is widely used for treating ovarian cancer and Kaposi's sarcoma. Encapsulation of doxorubicin in highly complex polyethylene glycol-coated (stealth) liposomes prolongs residence time and avoids the systemic toxicity associated with administration of the free drug. Small variations in physicochemical properties introduced during manufacture of liposomes can influence the payload of encapsulated drug, stability of liposomes under physiological conditions, and release of drug at the target tissue. Accordingly, the US Food and Drug Administration and the European Medicines Agency have issued guidance for manufacturers of generic liposomal doxorubicin that is designed to ensure that more than 30 physicochemical parameters that influence its safety and efficacy should be similar in the generic and reference listed drugs. OBJECTIVE: This study aims to describe the physicochemical characterization procedures used to ensure consistency between batches of generic liposomal doxorubicin and with the reference listed drug. METHODS: A range of spectroscopic, chromatographic, and other physicochemical tests was used to compare relative concentrations of liposome components, liposome morphology, ratios of free/entrapped doxorubicin, stability, and in vitro doxorubicin release rates in physiologically and clinically relevant media. RESULTS: The tests established that generic and reference liposomes contained similar concentrations of drug, lipids, and excipients and that their physical forms were also similar. CONCLUSION: The results of the tests demonstrate the physicochemical equivalence of generic liposomal doxorubicin hydrochloride and the reference listed drug, Doxil®/Caelyx®. Biochemical and clinical equivalence must also be demonstrated to fully meet regulatory requirements for generic liposomal medicines, and these are the subjects of separate studies.


Assuntos
Antibióticos Antineoplásicos/química , Doxorrubicina/análogos & derivados , Antibióticos Antineoplásicos/administração & dosagem , Química Física , Doxorrubicina/administração & dosagem , Doxorrubicina/química , Liberação Controlada de Fármacos , Humanos , Concentração de Íons de Hidrogênio , Tamanho da Partícula , Polietilenoglicóis/administração & dosagem , Polietilenoglicóis/química , Propriedades de Superfície
19.
BMJ Case Rep ; 20172017 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-29167214

RESUMO

The timely diagnosis of aortic dissection is notoriously confounded by unreliable symptomatology. We present a previously unreported clinical sign: thoracic pain reproduced by abdominal palpation. Our case illustrates the dependence of traditional clinical features on the anatomical location of an aortic dissection and lends weight to the concept of aortic pain as being a dynamic product of inter-related changes in intraluminal pressure, volume, wall stress and diameter. The clinical sign we describe may be very specific of acute aortic pathology.


Assuntos
Aneurisma Dissecante/patologia , Aorta Torácica/patologia , Dor no Peito/patologia , Aneurisma Dissecante/complicações , Dor no Peito/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Palpação/efeitos adversos
20.
Intern Med J ; 47(10): 1202-1205, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28994259

RESUMO

In this 'paired' case report, we describe two heart transplants performed 3 days apart at our centre. Both cases involved very prolonged transportation time of the donor heart. In one case, the donor heart was transported in an ice chest, while in the other case the organ was transported using a normothermic ex vivo perfusion (NEVP) system. The additional retrieval costs incurred by the use NEVP were more than offset by the reduction in subsequent inpatient costs.


Assuntos
Cardiomiopatias/cirurgia , Transplante de Coração/métodos , Tempo para o Tratamento , Sobrevivência de Tecidos/fisiologia , Doadores não Relacionados , Adolescente , Idoso , Cardiomiopatias/diagnóstico , Transplante de Coração/normas , Humanos , Masculino , Tempo para o Tratamento/normas
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