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Segura AM, Dris L, Massin EK, Clubb FJ, Buja LM, Frazier OH, Taegtmeyer H. Heart failure in remission for more than 13 years after removal of a left ventricular assist device. Tex Heart Inst J 2014; 41:389-94. [PMID: 25120391 DOI: 10.14503/thij-13-4029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Mechanical cardiac unloading with use of a left ventricular assist device (LVAD) is associated with substantial improvements in left ventricular function and enables subsequent LVAD explantation in some patients. We describe the case of a 35-year-old man with dilated nonischemic cardiomyopathy who was supported with an LVAD for 9 months. After the device was removed, he led a normal life for 13 years and 4 months. However, at 49 years of age, he presented with new signs and symptoms of heart failure, necessitating implantation of a 2nd LVAD. Afterwards, he has remained asymptomatic. This case is unique in that the patient lived a normal life for longer than a decade before renewed left ventricular decompensation necessitated repeat LVAD therapy. Histologic examination revealed few changes between the first device's removal in 1999 and the 2nd device's implantation in 2012.
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Affiliation(s)
- Ana Maria Segura
- Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030
| | - Lamia Dris
- Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030
| | - Edward K Massin
- Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030
| | - Fred J Clubb
- Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030
| | - L Maximilian Buja
- Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030
| | - O H Frazier
- Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030
| | - Heinrich Taegtmeyer
- Departments of Cardiovascular Pathology (Drs. Buja, Clubb, and Segura) and Cardiopulmonary Transplantation (Drs. Frazier, Massin, and Taegtmeyer), Texas Heart Institute; and Departments of Internal Medicine (Drs. Dris and Taegtmeyer) and Pathology and Laboratory Medicine (Dr. Buja), The University of Texas Medical School at Houston; Houston, Texas 77030
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Buja LM. The pathobiology of acute coronary syndromes: clinical implications and central role of the mitochondria. Tex Heart Inst J 2013; 40:221-228. [PMID: 23914009 PMCID: PMC3709209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Ongoing investigation has provided new insights into the pathobiology of myocardial ischemic injury. These include an improved understanding of the roles of the major modes of cell injury and death, including oncosis, apoptosis, and unregulated autophagy, as well as the central role of the mitochondria in the progression of myocardial ischemic injury, reperfusion injury, and myocardial conditioning. This understanding is providing insights for developing new pathophysiologic, pharmacologic, and cell-based therapies, alone or in combination with percutaneous coronary interventions, for better preservation of myocardium and reduction of morbidity and mortality rates from ischemic heart disease.
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Affiliation(s)
- L Maximilian Buja
- Cardiovascular Pathology Research Laboratory, Texas Heart Institute, Houston, Texas 77030, USA.
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