Left atrial thrombosis after heart transplantation

Castedo, Evaristo; Burgos, R.; Cañas, Alfonso; Cabo, Rubén A.; Serrano-Fiz, Santiago; Segovia, Javier; Ugarte, Juan

doi:10.1016/s0967-2109(03)00021-8

Cited by 4 publications

(6 citation statements)

References 5 publications

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“…Cardioembolism may also arise by mechanisms other than AF: after standard OHT, the enlarged resultant atria may promote atrial thrombosis [ 59 ]; in this regard, Heroux observed that the incidence of echo-contrast or thrombi in the left atrium is significantly lower in patients having undergone the bicaval anastomosis technique at the time of transplantation then the standard biatrial anastomosis [ 14 ]. Despite an uneventful post-operative course, sinus rhythm and normal contractility of the heart, large thrombi could be found up to several months following transplantation [ 60 - 62 ]. Hotson reported a patient with an occlusion of left internal carotid artery with extensive infarction of the left cerebral hemisphere caused by a cardioembolic mechanism due to a left atrial mural thrombus [ 27 ].…”

Section: Pathogenesismentioning

confidence: 99%

Ischemic Stroke after Heart Transplantation

et al. 2016

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Cerebrovascular complications after orthotopic heart transplantation (OHT) are more common in comparison with neurological sequelae subsequent to routine cardiac surgery. Ischemic stroke and transient ischemic attack (TIA) are more common (with an incidence of up to 13%) than intracranial hemorrhage (2.5%). Clinically, ischemic stroke is manifested by the appearance of focal neurologic deficits, although sometimes a stroke may be silent or manifests itself by the appearance of encephalopathy, reflecting a diffuse brain disorder. Ischemic stroke subtypes distribution in perioperative and postoperative period after OHT is very different from classical distribution, with different pathogenic mechanisms. Infact, ischemic stroke may be caused by less common and unusual mechanisms, linked to surgical procedures and to postoperative inflammation, peculiar to this group of patients. However, many strokes (40%) occur without a well-defined etiology (cryptogenic strokes). A silent atrial fibrillation (AF) may play a role in pathogenesis of these strokes and P wave dispersion may represent a predictor of AF. In OHT patients, P wave dispersion correlates with homocysteine plasma levels and hyperhomocysteinemia could play a role in the pathogenesis of these strokes with multiple mechanisms increasing the risk of AF. In conclusion, stroke after heart transplantation represents a complication with considerable impact not only on mortality but also on subsequent poor functional outcome.

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Section: Pathogenesismentioning

confidence: 99%

Ischemic Stroke after Heart Transplantation

et al. 2016

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“…Тромбоз, как пра-вило, формируется в области шва левого предсер-дия, в местах, где отсутствует эндотелизация. Для профилактики развития тромбоза левого предсер-дия донорского сердца рекомендуется выполнение левопредсердного анастомоза по методике «выво-рачивающего» сосудистого шва, что обеспечивает соприкосновение эндотелизированных поверхнос-тей донорского и реципиентского частей общего левого предсердия [17].…”

Section: Discussionunclassified

Successful Treatment of a Recipient With Massive Thrombosis of Heart Transplant Left Chambers During Extracorporeal Membrane Oxygenation

Попцов

Захаревич

Спирина

et al. 2016

RJTAO

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1 ФГБУ «ФНЦ трансплантологии и искусственных органов им. акад. В.И. Шумакова» Минздрава России, Москва, Российская Федерация 2 Кафедра трансплантологии и искусственных органов ГБОУ ВПО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России, Москва, Российская Федерация Представлен клинический случай успешного лечения реципиента сердца с тотальным тромбозом левого предсердия и левого желудочка, развившимся в ранние сроки после трансплантации на фоне применения периферической ВА ЭКМО как метода механической поддержки кровообращения при острой право-желудочковой недостаточности пересаженного сердца. Пациенту успешно выполнили хирургическую тромбэктомию, и ВА ЭКМО прекращена на первые сутки после операции.Ключевые слова: трансплантация сердца, экстракорпоральная мембранная оксигенация, тромбоз левого желудочка, активированное время свертывания. We present a case report of a 16-year-old man with venoarterial extracorporeal membrane oxygenation (VA-ECMO) for primary graft failure after orthotopic heart transplantation who developed left atrium and left ventricular thrombosis despite systemic anticoagulation. The surgical thrombectomy was performed and the patient was successfully weaned off the extracorporeal support on the fi rst day thereafter. SUCCESSFUL TREATMENT OF A RECIPIENT WITH MASSIVE THROMBOSIS OF HEART TRANSPLANT LEFT CHAMBERS DURING EXTRACORPOREAL MEMBRANE OXYGENATION

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“…Cardiac thrombosis is a rare complication of heart transplantation and it usually presents as an incidental finding during follow up . It was hypothesized that hemostatic alterations, cardiac arrhythmias, graft rejection, and anatomic changes after transplant cause thrombus formation .…”

Section: Discussionmentioning

confidence: 99%

“…The transplanted heart is predisposed to small left atrial (LA) thrombi due to anatomic and physiologic changes . Stasis in a poorly functioning heart on extracorporeal membrane oxygenation (ECMO) support can also promote thrombus formation .…”

mentioning

confidence: 99%

“…Stasis in a poorly functioning heart on extracorporeal membrane oxygenation (ECMO) support can also promote thrombus formation . However, the incidence of thrombosis in either situation is relatively low . We experienced a case of near‐complete thrombosis of the LA shortly after orthotopic heart transplantation (OHT) while on ECMO support due to donor heart dysfunction.…”

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confidence: 99%

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Massive Thrombosis of the Transplanted Heart in the Early Postoperative Period

et al. 2015

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We experienced a case with the left atrium almost completely filled with a thrombus after orthotopic heart transplantation while the patient was supported on extracorporeal membrane oxygenation for primary graft failure. The patient had recurrent thrombosis even after successful surgical thrombectomy and appropriate anticoagulation. The cardiac thrombosis resolved only after starting plasmapheresis.

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Left atrial thrombosis after heart transplantation

Cited by 4 publications

References 5 publications

Ischemic Stroke after Heart Transplantation

Ischemic Stroke after Heart Transplantation

Successful Treatment of a Recipient With Massive Thrombosis of Heart Transplant Left Chambers During Extracorporeal Membrane Oxygenation

Massive Thrombosis of the Transplanted Heart in the Early Postoperative Period

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