Aortic Valve Endocarditis in a Transplanted Heart After Urethral Instrumentation

Unić, Daniel; Starčević, Boris; Sičaja, Mario; Barić, Davor; Rudež, Igor; Biočić, Stanko; Varvodić, Josip; Sutlić, Željko

doi:10.1016/j.athoracsur.2013.03.113

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…Endocarditis represents a rare but life-threatening condition after heart transplantation [ 63 ]: this condition may also cause a cardioembolic stroke. Adair reported a patient with an ischemic stroke caused by an infective endocarditis on the second postoperative day, evaluated with an echocardiogram showing a mobile vegetation along the left atrial suture line [ 13 ].…”

Section: Pathogenesismentioning

confidence: 99%

Ischemic Stroke after Heart Transplantation

et al. 2016

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Cerebrovascular complications after orthotopic heart transplantation (OHT) are more common in comparison with neurological sequelae subsequent to routine cardiac surgery. Ischemic stroke and transient ischemic attack (TIA) are more common (with an incidence of up to 13%) than intracranial hemorrhage (2.5%). Clinically, ischemic stroke is manifested by the appearance of focal neurologic deficits, although sometimes a stroke may be silent or manifests itself by the appearance of encephalopathy, reflecting a diffuse brain disorder. Ischemic stroke subtypes distribution in perioperative and postoperative period after OHT is very different from classical distribution, with different pathogenic mechanisms. Infact, ischemic stroke may be caused by less common and unusual mechanisms, linked to surgical procedures and to postoperative inflammation, peculiar to this group of patients. However, many strokes (40%) occur without a well-defined etiology (cryptogenic strokes). A silent atrial fibrillation (AF) may play a role in pathogenesis of these strokes and P wave dispersion may represent a predictor of AF. In OHT patients, P wave dispersion correlates with homocysteine plasma levels and hyperhomocysteinemia could play a role in the pathogenesis of these strokes with multiple mechanisms increasing the risk of AF. In conclusion, stroke after heart transplantation represents a complication with considerable impact not only on mortality but also on subsequent poor functional outcome.

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Section: Pathogenesismentioning

confidence: 99%

Ischemic Stroke after Heart Transplantation

et al. 2016

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“…In this review, AR is identified on 14 occasions, two of which are concomitant with aortic root enlargement, and one of the cases presented includes infective endocarditis. [ 27 - 29 ] The number of occasions was less than TR because left-sided valves are less affected by degenerative processes. [ 30 ]…”

Section: Discussionmentioning

confidence: 99%

“…Kyranis et al [34] 2016 Case report Gopalamurugan et al [41] 2014 Case report Holmes et al [6] 2014 Retrospective 912 10 46 80 7. 48 Unic et al [29] 2013 Case report…”

Section: Patient Demographicsmentioning

confidence: 98%

Management options of valvular heart diseases after heart transplantation: A scoping review

Yilmaz,

Keenan

2024

Turk Gogus Kalp Dama

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Background: This study aimed to outline the valvular changes following heart transplantation and describe the management options to address these conditions. Methods: A literature search using EMBASE, MEDLINE, and PubMed databases was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in this study. Clinical studies involving patients who had their first heart transplant and articles that mentioned management for valvular heart disease were included. Treatment options were grouped into four categories: cardiac surgery other than retransplant and valve surgery, valve replacement and repairs, nonsurgical interventions, and conservative management. Results: Nine hundred and three (6.56%) patients out of 13,757 patients (10,529 males, 3,228 females; mean age: 60.3±10.4 years; range, 20 to 83 years) undergoing heart transplantation were identified with valvular disease affecting one or more valves. The mean interval between the transplant and the diagnosis of valve disease was 11.31±6.95 years. The most common valvular heart disease was tricuspid regurgitation, with 796 (94.09%) occurrences, followed by mitral regurgitation (n=22, 2.6%), aortic regurgitation (n=14, 1.65%), aortic stenosis (n=11, 1.3%), and mitral stenosis (n=3, 0.35%). Additionally, the number of surgical valve replacement and repairs (n=89) was higher than nonsurgical interventions (n=20). Conclusion: Acquired valvular heart diseases after cardiac transplantation are an infrequent clinical presentation that can cause valvular changes in the recipient. According to the extracted data, there is no sole superior management option, and more research is needed in this area.

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“…Single-center case reports have reported acceptable perioperative outcomes ( 16 , 31 – 33 ), and case reports on TAVR in HTX patients with high surgical risk have presented data on favorable short-term outcomes ( 4 – 8 ); however, long-term data, as well as data are data on the durability of biological and mechanical valves, are lacking. Aortic valve endocarditis after HTX is extremely rare ( 34 ). Our cohort included a patient with biological valve replacement due to endocarditis and 7.7 years of follow-up without valvular degeneration.…”

Section: Discussionmentioning

confidence: 99%

Indications, Complications, and Outcomes of Cardiac Surgery After Heart Transplantation: Results From the Cash Study

Gökler

Aliabadi-Zuckermann

Kaider

et al. 2022

Front. Cardiovasc. Med.

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BackgroundAllograft pathologies, such as valvular, coronary artery, or aortic disease, may occur early and late after cardiac transplantation. Cardiac surgery after heart transplantation (CASH) may be an option to improve quality of life and allograft function and prolong survival. Experience with CASH, however, has been limited to single-center reports.MethodsWe performed a retrospective, multicenter study of heart transplant recipients with CASH between January 1984 and December 2020. In this study, 60 high-volume cardiac transplant centers were invited to participate.ResultsData were available from 19 centers in North America (n = 7), South America (n = 1), and Europe (n = 11), with a total of 110 patients. A median of 3 (IQR 2–8.5) operations was reported by each center; five centers included ≥ 10 patients. Indications for CASH were valvular disease (n = 62), coronary artery disease (CAD) (n = 16), constrictive pericarditis (n = 17), aortic pathology (n = 13), and myxoma (n = 2). The median age at CASH was 57.7 (47.8–63.1) years, with a median time from transplant to CASH of 4.4 (1–9.6) years. Reoperation within the first year after transplantation was performed in 24.5%. In-hospital mortality was 9.1% (n = 10). 1-year survival was 86.2% and median follow-up was 8.2 (3.8–14.6) years. The most frequent perioperative complications were acute kidney injury and bleeding revision in 18 and 9.1%, respectively.ConclusionCardiac surgery after heart transplantation has low in-hospital mortality and postoperative complications in carefully selected patients. The incidence and type of CASH vary between international centers. Risk factors for the worse outcome are higher European System for Cardiac Operative Risk Evaluation (EuroSCORE II) and postoperative renal failure.

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Aortic Valve Endocarditis in a Transplanted Heart After Urethral Instrumentation

Cited by 7 publications

References 6 publications

Ischemic Stroke after Heart Transplantation

Ischemic Stroke after Heart Transplantation

Management options of valvular heart diseases after heart transplantation: A scoping review

Indications, Complications, and Outcomes of Cardiac Surgery After Heart Transplantation: Results From the Cash Study

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