To summarize the case of combined heart-lung transplantation for a patient who survived for 8.5 years. On September 20, 2003, at Second Xiangya Hospital of Central South University, homologous heartlung transplantation was performed on a male patient who was diagnosed with cardiopulmonary failure secondary to congenital ventricular septal defect with severe pulmonary hypertension. Heart-lung allograft was preserved with 1500 mL modified St.Thomas solution and 3000 mL modified LPD solution. Postoperative immunosuppressive therapies included: methylprednisolone and human anti-lymphocyte globulin protein in the induction period; and combination of ciclosporin A, CellCept and prednisolone in the stable period. In 2007, the treatment was changed to CellCept mg, twice a day+FK506 4 mg, twice a day. The patient lived 8.5 years of normal life with cardiac function of NYHA I-II. Echocardiogram showed left ventricular ejection fraction of 61% to 74%. Heart-lung transplantation proved reliable therapy modality for terminal cardiopulmonary failure. Excellent donor organ preservation and proper perioperative treatment are key factors for long-term survival after heart-lung transplantation.
Eisenmenger Complex ; surgery ; Follow-Up Studies ; Graft Rejection ; Heart Septal Defects, Ventricular ; complications ; surgery ; Heart-Lung Transplantation ; methods ; Humans ; Hypertension, Pulmonary ; etiology ; surgery ; Immunosuppressive Agents ; therapeutic use ; Male ; Young Adult

Objective:To investigate the relationship between indicators of carotid atherosclerosis and onset of ischemic stroke in patients with non-valvular atrial fibrillation (NVAF).Methods:This is a case-control study, a total of 397 NVAF patients with newly diagnosed ischemic stroke (case group) and 3 038 NVAF patients without ischemic stroke (control group) from January 2015 to December 2017 were included in the study. Differences in general clinical features and carotid atherosclerosis indexes between the two groups were compared. Univariate and multivariate logistic regressions were used to analyze the correlation between carotid atherosclerosis indexes and ischemic stroke.Results:Proportions of patients with carotid intima thickening, carotid plaque, stable plaque, unstable plaque, and moderate to severe stenosis were higher in the ischemic stroke group than those in the control group (82.1% vs. 64.4%, 69.3% vs. 50.3%, 43.6% vs. 30.6%, 25.7% vs. 19.7%, and 7.3% vs. 4.0%, respectively, all P <0.05). After adjustment of age, gender, heart failure, hypertension, low density lipoprotein -cholesterol and drug use, multivariate analyses showed that subjects with carotid intima thickening, carotid plaque, stable plaque, unstable plaque, moderate to severe stenosis had 1.766, 2.111, 1.892, 2.256 and 1.824 times the risk for the development of ischemic stroke compared with the subjects without any carotid atherosclerosis indicators. Conclusion:Carotid atherosclerosis, especially with unstable carotid plaque, is associated with ischemic stroke in patients with NVAF.