Category Archives: AoP

Warburg effect in B-cell lymphoma: A case report and proposed management plan

Stefan Gligor, Salim Abdelhamid, Veronika Ballova, Andrea Kopp Lugli

Baden Cantonal Hospital, Baden, Switzerland

DOI: 10.2478/jccm-2025-0045

Introduction: The Warburg effect is a rare but often fatal condition in patients with malignancies. This phenomenon, known as type B lactic acidosis, is defined by lactatemia without tissue hypoxia or hypoperfusion, in contrast to type A lactic acidosis, which usually results from either or both.
Case presentation: A male patient in his seventies with a newly diagnosed diffuse large B-cell lymphoma is admitted to the intensive care unit due to severe metabolic derangements with hypoglycemia and lactatemia. Extensive investigations ruled out alternative etiologies, strongly suggesting the Warburg effects as the underlying mechanism. Despite hemodynamic instability, chemotherapy was initiated and resulted in initial clinical improvement.
Conclusion: We propose a stepwise approach to improve the management of patients with suspected type B lactic acidosis.

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Right ventricular failure after LVAD support: A challenging case of bridge to heart transplantation in end-stage dilated cardiomyopathy

Horatiu Suciu1,2, Emanuel-David Anitei2, Paul Calburean3, Marius Mihai Harpa1,2

1 Department of Surgery IV, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2 Department of Cardiovascular Surgery, Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Romania
3 Department of Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, Romania

DOI: 10.2478/jccm-2025-0038

Introduction: End-stage heart failure due to dilated cardiomyopathy remains a major indication for advanced mechanical circulatory support and heart transplantation. Left ventricular assist devices have emerged as a vital bridge to transplant, improving survival and functional status. However, right ventricular failure following LVAD implantation is a significant and potentially fatal complication, requiring careful management to optimize outcomes.
Case presentation: We present the case of a 46-year-old male with post-myocarditis dilated cardiomyopathy, severely reduced left ventricular ejection fraction (21%), severe functional mitral and tricuspid regurgitation, and NYHA class IV heart failure. Despite optimal medical therapy, including inotropic support, the patient progressed to multiorgan dysfunction necessitating renal replacement therapy. A HeartMate 3 LVAD was implanted as a bridge to transplantation. The postoperative course was complicated by severe right ventricular failure, requiring prolonged inotropic support and careful hemodynamic management. Despite these challenges, the patient successfully underwent orthotopic heart transplantation. His postoperative evolution was favorable, with stable graft function and good clinical recovery documented during follow-up.
Conclusion: Right ventricular failure remains a major complication following LVAD implantation, significantly impacting outcomes. While LVADs have revolutionized the management of end-stage heart failure, heart transplantation continues to represent the definitive therapy offering superior long-term survival.

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