Document Detail


Bicaval versus standard technique in orthotopic heart transplant: assessment of atrial performance at magnetic resonance and transthoracic echocardiography.
MedLine Citation:
PMID:  22217865     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite a more physiological morphology of atrial anastomosis in the bicaval technique with respect to standard biatrial anastomosis in orthotopic heart transplantation (OHT), the impact on the long-term outcome is still not clear. In this retrospective study, we sought to investigate the morphology and function of the atria through magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE). Moreover, we aimed to analyse the accuracy of TTE with respect to MRI. Cox regression analysis of 216 consecutive patients receiving OHT between August 1987 and January 2010 identified only recipient age at the time of transplant to be an independent predictor of mortality (P = 0.048, odds ratio = 1.04). After a mean follow-up of 96.6 ± 77.7 months, 108 patients were alive, of which 35 were found to be eligible for MRI assessment. In this analysis, left and right atrial volumes were found to be significantly larger in the standard group in comparison with the bicaval group (P = 0.001), and no significant difference between the two techniques was observed in left and right atrio-ventricular output. Moreover, a significantly reduced accuracy was observed (CCC < 0.3) when TTE results were compared with MRI assessment in evaluating atrial dimensions. Although left and right atrial volumes are significantly larger in the standard group in comparison with the bicaval group, we concluded that no significant difference in the atrial output and survival between the two techniques could be demonstrated.
Authors:
Angelo Maria Dell'Aquila; Stefano Mastrobuoni; Gorka Bastarrika; Beltran Levy Praschker; Pedro Azcárate Agüero; Sara Castaño; Jesus Herreros; Gregorio Rabago
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2012-01-04
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  14     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-22     Completed Date:  2012-07-24     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  457-62     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Clinical University of Navarra, Pamplona, Spain. am.dellaquila@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Anastomosis, Surgical
Atrial Function, Left*
Atrial Function, Right*
Echocardiography*
Female
Heart Atria / physiopathology,  surgery,  ultrasonography
Heart Transplantation / adverse effects,  methods*,  mortality
Humans
Kaplan-Meier Estimate
Linear Models
Magnetic Resonance Imaging*
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Predictive Value of Tests
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Spain
Time Factors
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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