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European Journal of Cardio-Thoracic Surgery, Vol 3, 262-266, Copyright © 1989 by European Association for Cardio-thoracic Surgery
H Shafei, JD Briggs and WH Bain
Seven patients underwent coronary revascularisation 12-145 months (mean:
63.4 months) after receiving cadaver renal transplants. There was no
operative mortality and in all patients satisfactory renal function was
maintained perioperatively. Hospital stay ranged from 7 days to 10 days
(mean: 8 days). During the period of follow-up (5-72 months, mean: 35
months): one patient remained angina-free at 7 months postoperatively; one
patient developed meningitis with Listeria monocytogenes 9 weeks after
surgery, and died of streptococcal septicaemia 11 weeks later. The other
five patients (71.4%) developed recurrence of angina requiring antianginal
therapy, and three of them sustained myocardial infarctions. Three patients
developed intermittent claudication, two of whom sustained acute leg
ischaemia. Two patients developed heart failure, one of whom died 38 months
postoperatively. In four patients who were restudied with cardiac
catheterisation and coronary angiography (2-17 months postoperatively)
there was evidence of progression of the coronary arterial disease in
three, although all coronary grafts were patent. Renal function remained
satisfactory in 5 patients, and deteriorated in two patients; in one
secondary to advanced heart failure; and in one as a terminal event
secondary to septicaemia. Although patients with renal transplants can
safely undergo open cardiac procedures, the long-term results of coronary
surgery are adversely affected by the progressive disease from which they
suffer.
ARTICLES
Follow-up after coronary revascularisation in patients with renal transplants
Department of Cardiothoracic Surgery, Western Infirmary, Glasgow, UK.
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S. N. Mitruka, B. P. Griffith, R. L. Kormos, B. G. Hattler, F. A. Pigula, R. Shapiro, J. J. Fung, and S. M. Pham Cardiac Operations in Solid-Organ Transplant Recipients Ann. Thorac. Surg., November 1, 1997; 64(5): 1270 - 1278. [Abstract] [Full Text] |
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