Cardiac surgery for Chagas disease

Magarakis, Michael; Macias, Alejandro E.; Tompkins, Bryon A.; Reis, Victor S; Loebe, Matthias; Batista, Randas J.V.; Salerno, Tomás A.

doi:10.1111/jocs.13795

Cited by 4 publications

(5 citation statements)

References 39 publications

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“…Survival per year has been estimated at 71% and at ten years at 46% post-transplant. However, there is a risk of disease reactivation secondary to post-transplant immunosuppression, although the evidence indicates that this could be treated with antimicrobial therapy as described above [159,160].…”

Section: Surgical Treatment 721 Heart Transplantmentioning

confidence: 99%

“…There is a 70% rate of parasitic recurrence within the first year after heart transplantation, with a 10% mortality rate in chagasic recipients [162]. Some studies show that a reduced immunosuppressive regimen does not increase allograft rejection in patients and is associated with lower rates of CD reactivation; studies have been conducted where azathioprine/cyclosporine combination causes less reactivation compared to mycophenolate [160]. Currently, infection and rejection are the leading causes of death among CD heart transplant recipients, occurring in 21% and 10-14% of patients, respectively [161].…”

Section: Surgical Treatment 721 Heart Transplantmentioning

confidence: 99%

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Chagas Heart Disease: Beyond a Single Complication, from Asymptomatic Disease to Heart Failure

Montalvo-Ocotoxtle

Rojas‐Velasco

Rodríguez-Morales

et al. 2022

JCM

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Chagas cardiomyopathy (CC), caused by the protozoan Trypanosoma cruzi, is an important cause of cardiovascular morbidity and mortality in developing countries. It is estimated that 6 to 7 million people worldwide are infected, and it is predicted that it will be responsible for 200,000 deaths by 2025. The World Health Organization (WHO) considers Chagas disease (CD) as a Neglected Tropical Disease (NTD), which must be acknowledged and detected in time, as it remains a clinical and diagnostic challenge in both endemic and non-endemic regions and at different levels of care. The literature on CC was analyzed by searching different databases (Medline, Cochrane Central, EMBASE, PubMed, Google Scholar, EBSCO) from 1968 until October 2022. Multicenter and bioinformatics trials, systematic and bibliographic reviews, international guidelines, and clinical cases were included. The reference lists of the included papers were checked. No linguistic restrictions or study designs were applied. This review is intended to address the current incidence and prevalence of CD and to identify the main pathogenic mechanisms, clinical presentation, and diagnosis of CC.

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Section: Surgical Treatment 721 Heart Transplantmentioning

confidence: 99%

Section: Surgical Treatment 721 Heart Transplantmentioning

confidence: 99%

Chagas Heart Disease: Beyond a Single Complication, from Asymptomatic Disease to Heart Failure

Montalvo-Ocotoxtle

Rojas‐Velasco

Rodríguez-Morales

et al. 2022

JCM

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“…An estimated 8 million people are infected with T. cruzi worldwide, with most infections occurring in South and Central America [159]. Operation may be indicated in the chronic phase, which can affect the gastrointestinal tract causing megacolon and mega-esophagus (10% of infected patients) or the heart, resulting in dilated cardiomyopathy (30%) [160][161][162].…”

Section: Chagas Diseasementioning

confidence: 99%

Surgical Infections in Low- and Middle-Income Countries: A Global Assessment of the Burden and Management Needs

Rickard

Beilman

Forrester

et al. 2020

Surgical Infections

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Background: The burden of surgical infections in low-and middle-income countries (LMICs) remains poorly defined compared with high-income countries. Although there are common infections necessitating surgery prevalent across the world, such as appendicitis and peptic ulcer disease, other conditions are more localized geographically. To date, comprehensive assessment of the burden of surgically treatable infections or sequelae of surgical infections in LMICs is lacking. Methods: We reviewed the literature to define the burden of surgical infections in LMICs and characterize the needs and challenges of addressing this issue. Results: Surgical infections comprise a broad range of diseases including intra-abdominal, skin and soft tissue, and healthcare-associated infections and other infectious processes. Treatment of surgical infections requires a functional surgical ecosystem, microbiology services, and appropriate and effective antimicrobial therapy. Systems must be developed and maintained to evaluate screening, prevention, and treatment strategies. Solutions and interventions are proposed focusing on reducing the burden of disease, improving surveillance, strengthening antibiotic stewardship, and enhancing the management of surgical infections. Conclusions: Surgical infections constitute a large burden of disease globally. Challenges to management in LMICs include a shortage of trained personnel and material resources. The increasing rate of antimicrobial drug resistance, likely related to antibiotic misuse, adds to the challenges. Development of surveillance, infection prevention, and antimicrobial stewardship programs are initial steps forward. Education is critical and should begin early in training, be an active process, and be sustained through regular programs.

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“…Серед кардіальних причин розвитку аневризм лівого шлуночка (АЛШ) окрім трансмурального інфаркту міокарда виявляють фістули коронарних артерій, інтрамуральний хід коронарних артерій, гі-пертрофічну кардіоміопатію, міокардит, аритмогенну кардіоміопатію правого шлуночка [1,2,3]. У літературі представлено поодинокі випадки виникнення АЛШ на тлі системних захворювань: інфекційного генезу (хвороба Чагаса, хвороба Бехчета, туберкульоз), сполучної тканини (системний червоний вовчак, саркоїдоз), хвороб накопичення глікогену, синдрому гіперімуноглобуліну Е, а також формування АЛШ унаслідок травми грудної клітки [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. АЛШ у військовослужбовців є результатом несвоєчасної реваскуляризації інфаркт-залежної артерії [18], вогнепального поранення серця [19], травми грудної клітки [2,20].…”

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Urgent Cardiosurgical Treatment of a Military Servant with a Moving Thrombus in the Area of the Left Ventricular Apical Aneurysm (Case Report)

Gogayeva,

Nudchenko,

Malysheva

et al. 2024

ujcvs

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Against the background of military operations, post-traumatic stress disorder, the progression of the atherosclerotic process is observed, which can lead to myocardial infarction even in young people. Left ventricular aneurysm (LVA) in military personnel is the result of untimely revascularization of an infarct-related artery, gunshot wound to the heart, chest trauma, etc. The presence of a dyskinetic area promotes formation of blood clots in the LVA cavity. LVA thrombosis is associated with an increased risk of embolism, ischemic stroke, and death. Case description. A 37-year-old military servant A. was urgently hospitalized to the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a mobile thrombus in the area of LVA, size 4.5 x 3 cm, with signs of lysis and a threat of separation according to echo data. The patient was found to suffer Q-wave myocardial infarction 5 months ago; at the time of examination there was decompensation of the condition and a decrease in the left ventricular contractility to 34%. The patient underwent urgent operation: on-pump coronary artery bypass grafting, LVA resection with thrombectomy. The duration of the operation was 7 hours, the aortic cross-clamp time was 53 minutes, the perfusion time was 93 minutes, the blood loss was 500 ml. The postoperative period was uneventful. The patient was discharged on the 7th day with improvement, the ejection fraction was 40%. Conclusion. The lack of an opportunity to conduct timely electrocardiography and echo for military personnel with acute chest pain reduces the chances of diagnosis and treatment of myocardial infarction within the therapeutic window, which leads to the occurrence of complicated forms of coronary heart disease, namely LVA. Echo is of crucial importance in deciding on emergency cardiac surgery for thrombosed LVA.

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Cardiac surgery for Chagas disease

Cited by 4 publications

References 39 publications

Chagas Heart Disease: Beyond a Single Complication, from Asymptomatic Disease to Heart Failure

Chagas Heart Disease: Beyond a Single Complication, from Asymptomatic Disease to Heart Failure

Surgical Infections in Low- and Middle-Income Countries: A Global Assessment of the Burden and Management Needs

Urgent Cardiosurgical Treatment of a Military Servant with a Moving Thrombus in the Area of the Left Ventricular Apical Aneurysm (Case Report)

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