Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8–12% depending on the pump type and patient’s comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation. On February 17th, 2017 he was re-admitted with LVAD pump thrombosis. As fibrinolysis was contraindicated, an emergency pump exchange was performed via a limited thoracic incision in order to minimize surgical trauma, reduce intraoperative complications and facilitate immediate post-operative recovery. This report documents the very first LVAD pump exchange as well as the first one performed via a minimally invasive approach in Poland.
Phage tail-like particles, known as tailocins, are sophisticated nanomolecular machines with bactericidal activity. They are produced by various bacteria to gain fitness advantages in the environment, and hence they play a critical role in bacterial ecology across all known habitats. Here we characterized phage tail-like particles produced by Dickeya dadantii strain 3937 - one of the widest-characterized members of plant pathogenic Soft Rot Pectobacteriaceae (SRP). Tailocins were induced from D. dadantii strain 3937 cells with mitomycin C and visualized and characterized with microscopic techniques (TEM and AFM). They were ca. 166 nm long, tubes surrounded by contractive sheaths with baseplates with tail fibers at one end. Furthermore, we identified a 22-kb cluster in the genome of D. dadantii 3937 involved in their synthesis that expressed high homology to the cluster coding for the tail of the Enterobacteriophage P2. The D. dadantii 3937 tailocins were named dickeyocins P2D1 (=phage P2-like dickeyocin 1). P2D1 were prone to inactivation by pH (3.5-12), temperature (4-50 C), and elevated osmolarity (NaCl concentration: 0.01-1 M). P2D1 could kill different Dickeya spp.; however, they were unable to kill any strain of Pectobacterium spp. tested. Likewise, they were not toxic to Caenorhabditis elegans.
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