Browsing by Author "Michel, Sebastian"

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    Combination Antifungal Therapy for Invasive Pulmonary Aspergillosis in a Heart Transplant Recipient
    (Başkent Üniversitesi, 2011-08) Beiras-Fernandez, Andres; Kaczmarek, Ingo; Reichart, Bruno; Ueberfuhr, Peter; Michel, Sebastian; Nickel, Thomas; Bigdeli, Amir K.
    Invasive pulmonary aspergillosis is a severe complication after solid organ transplant, with a high mortality rate. We present a 45-year-old male heart transplant recipient who developed fever, progressive worsening of dyspnea, and productive cough without response to antibiotics. Diagnosis of invasive pulmonary aspergillosis was made based on clinical, laboratory, and radiographic findings. The patient was treated successfully with combined antifungal therapy (voriconazole and micafungin). This case report highlights the importance of a high degree of clinical suspicion to allow curative treatment of invasive aspergillosis and the efficiency of new antifungal drugs.
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    ECMO After Prolonged Cardiopulmonary Resuscitation as a Successful Bridge to Immediate Cardiac Retransplant in a 6-Year-Old Girl
    (Başkent Üniversitesi, 2012-04) Bigdeli, Amir Khosrow; Kaczmarek, Ingo; Sodian, Ralf; Schmitz, Christoph; Michel, Sebastian; Beiras-Fernandez, Andres; Deutsch, Marcus-André
    Heart failure, life-threatening arrhythmias, and sudden cardiac death are common complications in patients with advanced chronic cardiac allograft rejection—the major limiting factor of long-term survival after heart transplant. In patients with sustained cardiorespiratory arrest refractory to cardiopulmonary resuscitation extracorporeal membrane oxygenation therapy is a therapeutic option. We report the case of a 6-year-old girl with severe chronic allograft vasculopathy who was successfully bridged to cardiac retransplant through extracorporeal membrane oxygenation therapy after prolonged cardiopulmonary resuscitation. Our case demonstrates extracorporeal membrane oxygenation as a rescuing therapeutic option in high-risk, bridge-to-transplant patients, with cardiac arrest. Even after prolonged cardiopulmonary resuscitation, there were no neurologic events, and our patient recovered without any neurologic damage.
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    Off-Pump Coronary Surgery for Allograft Vasculopathy 8 Years After Heart Transplant
    (Başkent Üniversitesi, 2009-12) Michel, Sebastian; Vicol, Calin; Reichart, Bruno; Abicht, Jan; Ueberfuhr, Peter; Beiras-Fernandez, Andres; Kaczmarek, Ingo
    Cardiac allograft vasculopathy is a severe complication after heart transplant, and is the major cause of death in patients surviving 1 year after transplant. We present a 59-year-old patient undergoing off-pump, coronary artery bypass surgery, 8 years after heart transplant. Owing to toxic liver disease, the lipid lowering therapy with statins had to be stopped 6 years after transplant, and coronary artery disease developed rapidly within 2 years. Off-pump, coronary bypass surgery was performed using a new, multisuction cardiac positioner; a disposable stabilizer; and a proximal seal system to avoid clamping of the aorta. The patient received 3 bypass grafts: the left internal thoracic artery; to the left anterior descending coronary artery; 1 saphenous vein graft to the marginal branch of the circumflex artery; and 1 saphenous vein graft to the right coronary artery. His postoperative course was uneventful.