Radha S. Gopalan

Hemolysis from aortic regurgitation mimicking pump thrombosis in a patient with a HeartMate II left ventricular assist device: A case report

Device-related hemolysis leading to anemia is a recognized chronic complication of a left ventricular assist device (LVAD). With the increased usage of the LVAD in the management of end-stage heart failure, an increased number of complications are being recognized. We present a case where a combination of elevated mean arterial pressure and development of aortic regurgitation resulted in increased hemolysis, power spikes, and anemia, mimicking device thrombus, resulting in a diagnostic dilemma.

Role of total artificial heart in the management of heart transplant rejection and retransplantation: case report and review

Cardiac allograft rejection and failure may require mechanical circulatory support as bridge‐to‐retransplantation. Prognosis in this patient group is poor and implantable ventricular assist devices have had limited success due to organ failure associated with the high dose immunosuppression required to treat ongoing rejection. We present a case from our institution and the world‐wide experience utilizing the SynCardia CardioWest Total Artificial Heart (TAH‐t; SynCardia Systems, Inc., Tucson, AZ, USA) for replacement of the failing graft, recovery of patient and end‐organ failure with ultimate bridge to retransplantation. We present our experience and review of world‐wide experience for use of TAH‐t in this type patient.

Unusual Case of Nonbacterial Thrombotic Endocarditis Attributable to Primary Antiphospholipid Syndrome

A 54-year-old man was referred for cardiac evaluation before renal transplantation because of chronic renal failure. His medical history was remarkable for diabetes mellitus, hypertension, and 3 episodes of transient ischemic attack (the most recent was 3 years earlier). A transthoracic echocardiogram showed a large, mobile mass on the anterior leaflet of the mitral valve, with trivial mitral regurgitation (Figure 1; Movie I in the online-only Data Supplement). The mass was originally believed to be a fibroelastoma; endocarditis was not considered initially because of the absence of systemic symptoms. Transesophageal echocardiography showed a 1×2-cm mobile, echodense region on the A2 segment of the mitral valve leaflet (Figure 2 and Movie II in the online-only Data Supplement are 2-dimensional images; Figure 3 and …

Simultaneous Heart and Kidney Transplantation After Bridging With The CardioWest Total Artificial Heart

End-stage renal failure is often considered a relative contraindication for total artificial heart implantation due to the increased risk of mortality after transplantation. We report the successful treatment of a patient having heart and renal failure with the CardioWest (SynCardia Inc, Tucson, AZ) total artificial heart for bridge-to-cardiac transplantation of a heart and kidney.

Electro-acupuncture therapy in a patient with a total artificial heart

Interaction between the electrical system of implanted cardiovascular devices and electrical stimulation of acupuncture points (electro-acupuncture) can be life-threatening. As a result, there is reluctance to use this modality in patients who have been implanted with any cardiac device. A patient with a total artificial heart was successfully treated with electro-acupuncture for inflammatory arthritis without any adverse events. This case illustrates the safety of electro-acupuncture in patients with a total artificial heart.