Document Detail

Comparison of standard and bicaval approach in orthotopic heart transplantation: 10-year follow-up.
MedLine Citation:
PMID:  18404001     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The present study compared 86 patients who underwent orthotopic heart transplantation by bicaval and standard techniques. METHODS: Patients already followed in the first year after heart transplantation were studied at 10 years of follow-up, this time evaluating the prevalence of arrhythmias, conduction disturbances and mitral or tricuspid regurgitation. RESULTS: The following arrhythmias were observed: atrial fibrillation (one patient from the standard group), ventricular premature beats and ventricular fibrillation (each in one patient from the bicaval group). Conduction disturbances were found in 25 patients in the standard group (48.1%) and in 19 patients in the bicaval group (55.9%, P = 0.515). Twenty patients had a mono- or bifascicular block in the standard group (38.5%) versus 19 patients in the bicaval group (55.9%); furthermore, five patients in the standard group (9.6%) and none in the bicaval group had a permanent pacemaker (Fisher's exact test: P = 0.074). Mitral regurgitation was present in 13 (26.5%) and five (16.1%) patients, respectively, in the standard and bicaval groups (Fisher's exact test: P = 0.411): it was grade 1 in 12 and five patients and grade 2 in one and zero patients, respectively. Tricuspidal regurgitation was observed in 26 (53.1%) and 13 (41.9%) patients, respectively, in the standard and bicaval groups (Fisher's exact test: P = 0.366): it was grade 1 in 23 and 13 patients and grade 2 in three and zero patients, respectively. Cumulative survival was 75% at 10 years from transplant in this relatively old population of patients (mean age = 58 years). CONCLUSION: In conclusion, our data do not support any definite mandate for either of the surgical techniques.
Antonino M Grande; Roberto Gaeta; Carlo Campana; Catherine Klersy; Laura Riva; Andrea M D'Armini; Mario Viganò
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  9     ISSN:  1558-2027     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-11     Completed Date:  2008-08-26     Revised Date:  2009-05-28    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  493-7     Citation Subset:  IM    
Divisione Cardiochirurgia, Istituto di Chirurgia Generale e dei Trapianti d'Organo, Fondazione IRCCS Policlinico S. Matteo, Università degli Studi di Pavia, Pavia, Italy.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis,  etiology
Echocardiography, Doppler
Follow-Up Studies
Heart Transplantation / adverse effects,  methods*
Middle Aged
Mitral Valve Insufficiency / diagnosis,  etiology
Tricuspid Valve Insufficiency / diagnosis,  etiology

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