scholarly journals The nail flag sign in heart transplant recipients: case reports and review of the patients with the flag sign of the nail

2019 ◽  
Vol 25 (3) ◽  
Author(s):  
Philip R Cohen
2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Isath ◽  
S Perembeti ◽  
A Correa ◽  
S Rao ◽  
A Chahal ◽  
...  

Abstract Background Takotsubo cardiomyopathy (TC) is a reversible stress-induced myocardial dysfunction with increased sympathetic activity caused by excessive release of catecholamines playing a central role in its pathophysiology. The occurrence of TC in transplanted hearts is rare given the complete denervation done during transplantation. However, it has been demonstrated that 40% of transplant recipients undergo sympathetic re-innervation. There have only been case reports describing TC in post-transplant recipients. Purpose To evaluate the incidence, baseline characteristics and outcomes of TC occurring in heart transplant recipients using Healthcare Cost and Utilization Project (HCUP) National (nationwide) Inpatient Sample (NIS) in United States from 2009 to 2014. Methods Using NIS data, we identified patients who underwent cardiac transplantation using ICD9 procedure codes 37.5 and 33.6. Among these patients, we identified those admitted to the hospital with diagnosis of TC based on ICD-9-CM code 429.83. We presented categorical data as percentages and continuous data as mean or median as appropriate. Results We identified 257 hospitalizations for TC in heart transplant recipient patients. There was an approximately 9-fold increase in admissions from 11 in 2009 to 95 in 2014. Among patients with TC, the mean age was 65.3±1.8 years and majority were female (76.6%). A majority of patients were Caucasians (63%) followed by smaller proportion of African-Americans (13.2%). In-patient mortality in patients admitted with TC following heart transplant was 11.3% (n=29). During the hospitalization, 4.8% of patients had cardiogenic shock and 2.8% required mechanical circulatory support. The average length of stay for patients with TC was 16.6±3.3 days. The mean cost of hospitalization for these patients when adjusted for inflation were 237248±55709 dollars. Conclusion TC can still occur in substantially in heart transplant recipients and should be considered one of the differential diagnosis in transplant patients presenting to the hospital. Funding Acknowledgement Type of funding source: None


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vincent Tchana-Sato ◽  
Arnaud Ancion ◽  
Julien Tridetti ◽  
Natzi Sakalihasan ◽  
Marie Pierre Hayette ◽  
...  

Abstract Background There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients, especially in heart transplant recipients, with only a few case reports and case series described so far. Heart transplant recipients may be at particular high risk due to their comorbidities and immunosuppressed state. Case presentation This report describes the clinical course and the challenging management of early COVID-19 infection in two heart transplant recipients who tested positive for the SARS-CoV-2 virus in the perioperative period of the transplant procedure. The two patients developed a severe form of the disease and ultimately died despite the initiation of an antiviral monotherapy with hydroxychloroquine coupled with the interruption of mycophenolate mofetil. Conclusions These two cases illustrate the severity and poor prognosis of COVID-19 in the perioperative period of a heart transplant. Thorough screening of donors and recipients is mandatory, and the issue of asymptomatic carriers needs to be addressed.


2020 ◽  
Author(s):  
Vincent Tchana-Sato ◽  
Arnaud Ancion ◽  
Julien Tridetti ◽  
Natzi Sakalihasan ◽  
Marie pierre Hayette ◽  
...  

Abstract Background: There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients and especially in heart transplant recipients with only few case reports and case series described so far. Heart transplant recipients may be at particular high risk due to their comorbidities and immunosuppressed state. Case presentation: This report describes the clinical course and the challenging management of early COVID-19 infection in two heart transplants recipients who were tested positive for the SARS-CoV-2 virus in the perioperative period of the transplant procedure. The two patients developed a severe form of the disease, and ultimately died despite the initiation of an antiviral monotherapy with hydroxychloroquine coupled with the interruption of mycophenolate mofetil. Conclusions: These two cases illustrate the severity and the poor prognosis of COVID-19 in the perioperative period of a heart transplant. Thorough screening of donors and recipients is mandatory and the issue of asymptomatic carrier need to be addressed.


2020 ◽  
Vol 20 (10) ◽  
pp. 2916-2922 ◽  
Author(s):  
Luise Holzhauser ◽  
Laura Lourenco ◽  
Nitasha Sarswat ◽  
Gene Kim ◽  
Ben Chung ◽  
...  

2006 ◽  
Vol 5 (1) ◽  
pp. 40-40
Author(s):  
R BESTETTI ◽  
T THEODOROPOULOS ◽  
T SOUZA ◽  
M LIMA ◽  
E BURDMANN ◽  
...  

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