The acute effects of inhaled nitric oxide (NO) (40 ppm in air) on pulmonary (PVR) and systemic (SVR) vascular resistance were compared with those of an intravenous infusion of prostacyclin (24 micrograms/h) in 8 patients with severe pulmonary hypertension and 10 cardiac patients with normal values of PVR. 10 healthy volunteers were studied non-invasively.… (More)
BACKGROUND Transmyocardial laser revascularisation (TMLR) is used to treat patients with refractory angina due to severe coronary artery disease, not suitable for conventional revascularisation. We aimed in a randomised controlled trial to assess the effectiveness of TMLR compared with medical management. METHODS 188 patients with refractory angina were… (More)
A young woman, bedbound with severe pulmonary hypertension, responded to intravenous epoprostenol with a fall in pulmonary vascular resistance, improved oxygenation, and a rise in exercise tolerance. For thirteen months, continuous infusion of epoprostenol has enabled her to live independently at home.
Mr Wallwork began by emphasising that movement in this subject is so rapid that he could speak only of the situation today, tomorrow it will certainly have changed.
Chronic myelomonocytic leukaemia is an atypical myeloproliferative disorder with a natural history of progression to acute myeloid leukaemia, a complex and poorly understood response by the bone marrow to stress. Cardiac surgery activates many inflammatory cascades and may precipitate a systemic inflammatory response syndrome. We present a case of… (More)
Liver, heart, and lung replacement was performed in a woman with severe pulmonary hypertension, cardiorespiratory failure, and end-stage primary biliary cirrhosis. The main surgical considerations were the staging of the various parts of the operation in relation to cardiopulmonary bypass and performing the recipient procedures as expeditiously as possible… (More)
25 years of heart transplantation data were used to identify factors associated with patient survival and investigate changes over time. Analysis was performed across 5 time eras – pre-triple therapy, post-triple therapy to 1990 and the remaining 15 years through 2005 divided into 3 groups of 5 years each. Both short-and long-term survival improved with the… (More)
Combined transplantation of the heart, lung, and liver may be indicated in patients with either end-stage respiratory failure complicated by advanced liver disease or end-stage liver failure complicated by advanced lung disease. A retrospective review of nine patients who underwent combined heart-lung-liver transplantation in Cambridge (1986-99) was carried… (More)
Peripheral blood eosinophil counts (EOS) are undetectable in 40% blood samples sent for routine haematology at Papworth Hospital during the first 3 months after heart transplantation (HTx). Increases in EOS usually precede the development of allograft rejection by a median of 4 days. We compared the effects of cyclosporin (dose and total blood… (More)