Omar Cheema

Does Left Ventricular Assist Device Implantation Affect Driving Patterns in Patients With End-Stage Heart Failure?

Background In 2012, the Canadian Society of Cardiology indicated that patients supported with left ventricular assist device (LVAD) may drive a private vehicle 2 months after implantation, provided they are deemed clinically stable. Objective evidence supporting this recommendation is limited. We sought to compare data regarding driving habits in our patients following LVAD implantation. Citation: Pinniti M.et al. (2017) “Does Left Ventricular Assist Device Implantation Affect Driving Patterns in Patients With EndStage Heart Failure?” The VAD Journal, 3. doi: https://doi.org/10.13023/VAD.2017. 05 Editor-in-Chief: Maya Guglin, University of Kentucky Received: February 15, 2016 Accepted: March 16, 2017 Published: March 16, 2017

Favorable Outcomes of LVAD as Bridge to Simultaneous Heart-Kidney Transplantation

Chronic kidney disease (CKD) is an established risk factor for incident cardiovascular disease and progression of heart failure disease state, and is associated with decreased survival after left ventricular assist device (LVAD) therapy or heart transplantation (HT). Combined heart-kidney transplantation (HKT) compared with isolated HT recently has been shown to have survival advantage among patients whose estimated glomerular filtration rate is less than 37 ml/min/m2. Data on LVAD to HKT are limited.

Expecting the unexpected: right atrial mass in a transplant patient

We present a 71‐year‐old male, who had had a heart transplantation 24 years prior, who came to our clinic with a low‐grade fever and a new II/VI holosystolic murmur. Echocardiography showed a large mass in the right atrium with attachment near the junction of the right atrium and superior vena cava. The patient was taken to the operating room for resection of the mass. Microscopic evaluation was consistent with thrombus. Differential diagnosis of cardiac masses after cardiac transplant includes tumour, thrombus, and vegetation. Final diagnosis can be challenging; multimodality imaging and biopsy or resection often are required for final diagnosis.

Patterns of myocardial fibrosis by CMR in patients with conduction abnormalities

Cine and DE-CMR performed in a cohort of patients revealed that the presence of LBBB was more frequently associated with increases in LV volumes and depression in LV function, whereas RBBB or nonspecific conduction delay were more strongly associated with septal replacement fibrosis.

Real time three-dimensional echocardiography and endovascular stenting.

A 52‐year‐old male with HIV and chronic renal failure presented with 2‐day history of fever and chills. He had recent superior vena cava (SVC) stent placement for SVC stenosis following multiple dialysis‐catheter insertions. Patients blood cultures grew methicillin‐resistant staphylococcus aureus. Two‐dimensional (2D) echocardiography showed no vegetations. With high clinical suspicion, 2D transesophageal echocardiogram (TEE) was obtained and confi rmed no endocarditis and patent stent at SVC right atrial junction; however, entire stent was not visualized. Simultaneous three‐dimensional TEE provided superior views of SVC stent in cross‐sectional and longitudinal planes, clearly demonstrating patent stent without vegetations, stenosis, migration, or thrombosis.