Document Detail

Characteristics of extracoronary vascular disease in heart transplant recipient.
MedLine Citation:
PMID:  18462341     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Heart transplant candidates carry many of risk factors for vascular disease, and in addition, recipients continue to accumulate them following heart transplantation (HTx). However, very limited information is available on this entity. This study was designed to address characteristics of extracoronary vascular disease in heart transplant recipients. METHODS: This is a nonconcurrent cohort study of 402 patients who received HTx at the University of Washington between 1985 and 2004. Pretransplant arterial evaluation included carotid, lower extremity, and renal artery duplex studies. CT angiogram was obtained when indicated. Patients with severe arterial disease were excluded from the transplant list. Posttransplant vascular evaluation was done with the patient's history and physical examination. RESULTS: Median follow-up was 5.5 years. Seventy vascular diseases were detected in 49 patients (12% of study population). Patients with pretransplant vascular disease, compared to those without, were older at the HTx, carried the diagnosis of ischemic cardiomyopathy more commonly, and had more comorbidities including history of smoking, alcohol drinking, chronic obstructive pulmonary disease, and prior heart operations. The prevalence of vascular disease was 6% prior to HTx and it cumulatively increased up to 17% at 17 years after HTx. Nineteen percent of these diseases were the result of arterial traumas mostly caused by medical interventions. Fourteen patients developed abdominal aortic aneurysm (AAA) with two deaths. CONCLUSIONS: It is important for care providers to be aware of the high probability of vascular disease, to be familiar with vascular disease, and to provide appropriate prophylactic and therapeutic measures when evaluating this patient population.
Hiroo Takayama; Christopher T Salerno; Gabriel S Aldea; Edward D Verrier
Publication Detail:
Type:  Journal Article     Date:  2008-05-07
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  23     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-10-20     Completed Date:  2009-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  459-63     Citation Subset:  IM    
Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan.
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MeSH Terms
Cardiovascular Diseases / epidemiology,  etiology*,  pathology
Cohort Studies
Coronary Vessels / pathology*
Heart Transplantation / adverse effects*
Middle Aged
Retrospective Studies
Risk Factors
Washington / epidemiology

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