Document Detail


Management of peripheral vascular problems in recipients of cardiac allografts.
MedLine Citation:
PMID:  1460716     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Five hundred and twenty consecutive heart transplant cases (458 adult, 62 pediatric) were reviewed to assess the impact of peripheral vascular problems. Peritransplant interventions requiring vascular cannulation (e.g., intraaortic balloon pump procedures, catheterization of the right and left sides of the heart, femoral bypass) resulted in 10 complications that necessitated nine surgical procedures. Five aortic aneurysms (three infrarenal and two suprarenal) were resected. There was one death unrelated to the aneurysm resection. Sixteen patients had evidence of peripheral vascular disease (PVD). There were three deaths in this group, none directly related to the PVD. Three patients required vascular reconstruction (axillobifemoral, bilateral femoral distal and popliteal endarterectomy) in the posttransplant period, all for advanced ischemic symptoms. Except for one patient in whom ischemia-related ulcers developed on the heels, all patients had improved or stable symptoms that did not require intervention. There were no limb losses or vascular infections. We conclude that despite the rigors of posttransplant immunosuppression, patients with stable manifestations of PVD may successfully undergo heart transplantation and subsequent vascular reconstruction, when indicated, without prohibitive risk.
Authors:
A I Benvenisty; G J Todd; M Argenziano; J A Buda; K Reemtsma; C R Smith; E A Rose
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  16     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-01-08     Completed Date:  1993-01-08     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  895-901; discussion 901-2     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Columbia University College of Physicians and Surgeons, New York, NY.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aortic Aneurysm, Abdominal / epidemiology,  surgery
Arteriosclerosis / epidemiology,  surgery
Catheterization, Central Venous / adverse effects
Child, Preschool
Female
Heart Transplantation*
Humans
Immunosuppression
Intra-Aortic Balloon Pumping / adverse effects
Male
Middle Aged
Peripheral Vascular Diseases / epidemiology,  surgery*
Risk Factors
Treatment Outcome

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


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