Document Detail

Mechanical circulatory assistance after heart transplantation.
MedLine Citation:
PMID:  3309217     Owner:  NLM     Status:  MEDLINE    
Results with mechanical circulatory assistance for the treatment of profound cardiopulmonary failure after conventional heart surgery have been encouraging. Its usefulness after heart transplantation is not known. Since August 1982, eight patients (of 59 transplant patients) have required support 0 to 48 hours (mean, 19.5 hours) after transplantation. The ages of the patients ranged from 7 days to 52 years (mean, 28.4 years). Underlying recipient heart disease was ischemic in three patients, congenital in two, cardiomyopathic in two, and rheumatic in one patient. Preoperative North American Transplant Coordinators Organization (NATCO) classification was status 9 in one patient (on extracorporeal membrane oxygenation [ECMO]), status 1 in five patients, and status 3 in two patients. Reasons for graft failure, although usually multifactorial, were primarily pulmonary hypertension with right ventricular failure in five patients and pneumonia, hyperacute rejection, and fat embolus in one patient each. In three patients, there was a mismatch in graft size (too small in two adults and too large in one neonate). Graft ischemic times ranged from 75 to 229 minutes (mean, 171 minutes). Two patients received mechanical support with an intra-aortic balloon (IAB), three with ECMO, and three with a right ventricular assist device (RVAD). One of the patients on ECMO and two of the patients with an RVAD also had IABs. Duration of support ranged from 4 hours to 8 days (mean, 3.2 days). Initial hemodynamic stability was achieved in all patients. Complications were common, including sepsis in seven patients and kidney failure in five patients. Only three patients were weaned. One patient with pulmonary hypertension, who was treated with ECMO, died 36 hours after being weaned.(ABSTRACT TRUNCATED AT 250 WORDS)
K R Kanter; D G Pennington; L R McBride; L W Miller; M T Swartz; K S Naunheim; V L Willman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart transplantation     Volume:  6     ISSN:  0887-2570     ISO Abbreviation:  J Heart Transplant     Publication Date:    1987 May-Jun
Date Detail:
Created Date:  1987-11-10     Completed Date:  1987-11-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8604172     Medline TA:  J Heart Transplant     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  150-4     Citation Subset:  IM    
Department of Surgery, St. Louis University Medical Center, Missouri 63104.
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MeSH Terms
Assisted Circulation* / adverse effects,  instrumentation
Child, Preschool
Graft Rejection
Heart Transplantation*
Hypertension, Pulmonary / etiology
Infant, Newborn
Middle Aged
Pneumonia / etiology,  mortality
Postoperative Care*
Postoperative Complications
Pulmonary Embolism / etiology

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

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