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Cardiac allograft vasculopathy (CAV) is a progressive type of coronary artery disease in people who have had a heart transplant. [1] As the donor heart has lost its nerve supply there is typically no chest pain, and CAV is usually detected on routine testing. [2]
After a few years, the survival after repair is similar to EVAR or open surgery. This observation may be the result of durability problems with early endograft, with a corresponding need for additional procedures to repair endoleaks and other device-related issues. Newer, improved technology may reduce the need for such secondary procedures.
Less commonly, PTLD occurs after hematopoietic stem cell transplantation. The incidence varies by the type of transplantation: the lowest rates are seen with bone marrow transplants and liver transplants. The highest rates of PTLD are seen with lung and heart transplants, which is primarily due to the need for higher levels of immunosuppression.
Heart transplantation is reserved for those that do not respond to the aforementioned conventional medical therapies. [49] An implantable cardioverter-defibrillator (ICD) is sometimes required in those with cardiomyopathy or heart failure caused by myocarditis due to the risk of fatal ventricular arrhythmias. [31]
The acute or fulminant form of the disease (aGvHD) is normally observed within the first 10 to 100 days post-transplant, [9] [10] and is a major challenge to transplants owing to associated morbidity and mortality. [11] About one-third to one-half of allogeneic transplant recipients will develop acute GvHD. [10]
Other physical signs include a person in distress, positional chest pain, diaphoresis (excessive sweating); possibility of heart failure in form of pericardial tamponade causing pulsus paradoxus, and the Beck's triad of low blood pressure (due to decreased cardiac output), distant (muffled) heart sounds, and distension of the jugular vein (JVD ...
A beating heart awaiting transplant. American medical researcher Simon Flexner was one of the first people to mention the possibility of heart transplantation. In 1907, he wrote the paper "Tendencies in Pathology," in which he said that it would be possible one day by surgery to replace diseased human organs – including arteries, stomach, kidneys and heart.
Significant complications of the operation include bleeding, heart problems (heart attack, arrhythmias), stroke, infections (often pneumonia) and injury to the kidneys. Three coronary artery bypass grafts, a pedicled LITA to LAD and two saphenous vein grafts – one to the right coronary artery system and one to the obtuse marginal system.