Treatment of tachyarrhythmias in a patient with the long QT syndrome by autotransplantation of the heart and sinus node-triggered atrial pacing

Pfeiffer, Dietrich; Fiehring, H; Warnke, H; Pech, H; Jenssen, S

doi:10.1016/s0022-5223(19)34810-x

Cited by 11 publications

(4 citation statements)

References 11 publications

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“…The long-term results of an ex situ tumor resection are not clear since, to the best of our knowledge, only seven cases have been reported in the literature [5 -11]. In these cases, indication was not always based on tumorous heart disease but on reduction of giant left atria [21,22], ventricular rupture after mitral valve replacement [23], ventricular arrhythmias due to a Long QT syndrome [24], and otherwise untreatable angina pectoris [25,26]. In the past, heart transplantation has often been considered for Case Reports patients with heart tumors that did not present with any evidence of distant metastases.…”

Section: Discussionmentioning

confidence: 99%

Ex situ Resection of Primary Cardiac Tumors

Hoffmeier

Scheld²,

Tjan³

et al. 2003

Thorac cardiovasc Surg

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The prognosis of malignant heart tumors is pessimistic; 50% of patients die within 6 months. No optimal therapy has been established, and standardized therapeutic concepts have not been developed due to the low incidence of this disease. In most cases, chemotherapy and radiotherapy have not shown any survival benefit compared to surgical treatment. Obviously, radical resection of the tumor is the most important determinant for long-term survival. Here, we report on two patients in whom radical resection of heart tumors could be accomplished only after explantation of the heart.

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Section: Discussionmentioning

confidence: 99%

Ex situ Resection of Primary Cardiac Tumors

Hoffmeier

Scheld²,

Tjan³

et al. 2003

Thorac cardiovasc Surg

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“…Heart autotransplantation has been used in the treatment of various types of cardiac diseases, including cardiac masses situated on the posterior aspect of the heart that cover a wide area and are unreachable using conventional techniques; 1,2 long QT syndrome that presents with paroxysmal ventricular tachycardia refractory to medical therapy; 3 and Prinzmetal's angina unresponsive to medical therapy. 4 Another important use is in the treatment of giant left atrium.…”

Section: Introductionmentioning

confidence: 99%

Partial Cardiac Autotransplantation for Reduction of the Left Atrium

Erdoğan

Kırali

Göksedef

et al. 2004

Asian Cardiovasc Thorac Ann

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Various surgical procedures have been employed to treat a greatly enlarged left atrium. We review the use of partial cardiac autotransplantation to reduce left atrial volume in 7 patients with rheumatic mitral valve disease and left atrial and ventricular volume in 2 patients with idiopathic dilated cardiomyopathy. There were 5 males and 4 females aged 25 to 62 years. The patients with rheumatic etiology had atrial fibrillation, while those with dilated cardiomyopathy had sinus rhythm. The mitral valve was replaced in 6 patients and reconstructed in 3. Mean aortic cross clamp time in the operations involving isolated left atrial resection was 119 +/- 44 min. Mean left atrial volume fell from 331 mL to 92 mL, while mean left atrial diameter decreased from 8.6 cm to 4.7 cm. Sinus rhythm was restored in 5 of the 7 patients who had preoperative atrial fibrillation. There was no operative mortality. The patients with dilated cardiomyopathy died in the postoperative period, one on the 14th day from low cardiac output and the other on the 113th day from multiorgan failure. Partial cardiac autotransplantation can be effective in reducing heart chamber size in selected patients, especially those with giant left atrium.

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“…Duas alternativas cirúrgicas, visando à desnervação parcial ou total do coração têm sido consideradas: a simpatectomia cérvico-torácica 1 e o denominado autotransplante cardíaco com implante de marcapasso 4 A aplicação da técnica de autotransplante em 3 pacientes, preservando a integridade do sistema de condução, motivam a presente comunicação. aberto de maneira análoga à realizada para procedimentos da valva mitral.…”

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“…PFEIFFER et ali;4 relataram, em 1992, o primeiro caso com sucesso a médio prazo de autotransplante como tratamento da síndrome do QT longo. BARBERO-MARCIAL, M.; SOSA, E.; IKARI, N. M. ; RISO , A .…”

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Tratamento da síndrome do QT longo com a técnica de autotransplante cardíaco com preservação do sistema de condução: the cardiac autotransplantation technique with preservation of the conduction system

Barbero-Marcial¹,

Sosa²,

Ikari³

et al. 1995

Rev Bras Cir Cardiovasc

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RBCCV 44205-265 BARBERO-MARCIAL, M.; SOSA, E.; IKARI , N. M.; RISO , A. A.; CAMARGO, P. R.; PILEGGI, F.; JATENE, A. D. -Tratamento da síndrome do OT longo com a técnica de autotransplante cardíaco com preservação do sistema de condução. Rev. Bras. Gir. Gardiovasc., 10 (2):101-106,1995.RESUMO: A síndrome do OT longo é caracterizada por prolongação intermitente ou permanente do intervalo OT, taquicardias paroxísticas ventriculares (TVR) e morte súbita. Existem três casos publicados na literatura tratados cirurgicamente com a técnica do autotransplante cardíaco, com 1 paciente sobrevivente . Nos 3 casos foi necessária, após a operação, a utilização de marcapasso átrio-atrial ou atrioventricular. No InCór, entre outubro de 1993 e maio de 1994, 3 pacientes portadores desta síndrome, 1 do sexo feminino e 2 do masculino , com idades, respectivamente , de 10, 11 e 13 anos, foram submetidos a desnervação por autotransplante . No pré-operatório, apesar de dose máxima de B-bloqueadores, os freqüentes episódios de taquicardia ventricular não foram evitados. Com carga mínima o teste ergométrico provocava TVR . A retirada do órgão foi feita seccionando-se as veias cavas, aorta, tronco pulmonar e as veias pulmonares, com remanescente de átrio esquerdo. Assim, o sistema de condução permaneceu íntegro e o ritmo, sinusal. No pós-operatório os testes ergométricos realizados mostraram ausência de taquicardia ventricular. Considerando os resultados imediatos, julgamos que a técnica relatada de autotransplante cardíaco como método de completa desnervação pode ser empregada em pacientes portadores da síndrome do OT longo, com baixo risco cirúrgico e preservação do sistema de condução. DESCRITORES: Síndrome do OT longo, autotransplante cardíaco . Síndrome do OT longo, cirurgia. Autotransplante cardíaco. Transplante cardíaco, humano, autotransplante. INTRODUÇÃOA síndrome do OT longo é caracterizada por prolongação intermitente ou permanente do intervalo OT e taquicardias paroxísticas ventriculares, levando com freqüência a morte súbita 3 , 5 .

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Treatment of tachyarrhythmias in a patient with the long QT syndrome by autotransplantation of the heart and sinus node-triggered atrial pacing

Cited by 11 publications

References 11 publications

Ex situ Resection of Primary Cardiac Tumors

Ex situ Resection of Primary Cardiac Tumors

Partial Cardiac Autotransplantation for Reduction of the Left Atrium

Tratamento da síndrome do QT longo com a técnica de autotransplante cardíaco com preservação do sistema de condução: the cardiac autotransplantation technique with preservation of the conduction system

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