While the number of organ donations after circulatory death (DCD) continues to grow in the United States and worldwide, it is yet to be accepted universally as a viable option to serve patients on the waiting list. Donation after circulatory death was the topic of the 7th Innovations in Transplant Summit, hosted April 22 and 23 by Baylor University Medical Center (Baylor Dallas), part of Baylor Scott & White Health.
Baylor Scott & White All Saints Medical Center – Fort Worth now offers comprehensive care for patients with advanced heart failure, including left ventricular support devices and other mechanical circulatory support. The advanced heart failure team implanted its first LVAD in July.
Placement of a pulmonary artery catheter (PAC), commonly known as a Swan-Ganz catheter, provides hemodynamic data that is vital for clinicians treating patients with acute decompensated heart failure or cardiogenic shock. While routine use has been shown to not be beneficial, there are many instances in which hemodynamic monitoring through the use of a Swan is highly indicated.
Cardiogenic shock represents a dynamic set of conditions, presentation profiles and pathophysiologic mechanisms whose mortality has not changed in more than 20 years. While almost 75 percent is due to predominant left ventricular failure, a quarter is due to something else, such as a rupture or tamponade, right ventricle shock or acute severe mitral regurgitation.
Heart failure and diabetes are closely intertwined. Diabetes affects not only coronary artery blood flow, but also the myocardium. Patients with type 2 diabetes are at risk of heart failure due to intrinsic myocardial disease, resulting in increased myocardial hypertrophy, fibrosis and stiffness. This can also lead to a form of heart failure described in literature as diabetic cardiomyopathy.
