HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Martinelli, L. Articles by Vigano, M. Search for Related Content PubMed PubMed Citation Articles by Martinelli, L. Articles by Vigano, M.

European Journal of Cardio-Thoracic Surgery, Vol 9, 644-650, Copyright © 1995 by European Association for Cardio-thoracic Surgery

ARTICLES

Different results of cardiac transplantation in patients with ischemic and dilated cardiomyopathy

L Martinelli, M Rinaldi, C Pederzolli, N Pederzolli, C Goggi, V Mantovani, A Gavazzi, C Campana and M Vigano
Department of Cardiac Surgery, University of Pavia, Italy.

We retrospectively analyzed 275 consecutive transplanted patients, dividing them into group A (128 patients) affected by ischemic cardiomyopathy and group B (147 patients) affected by dilated cardiomyopathy. The difference in demographic, clinical and hemodynamic preoperative and postoperative data between the groups was studied; group A patients presented at transplantation with a less compromised hemodynamic picture, requiring inotrope infusion and mechanical assistance less frequently. The influence of etiology on early postoperative complications was also analyzed: group A patients needed postoperative mechanical assistance, inotrope, infusion and prolonged mechanical ventilation more often, therefore requiring a longer stay in the intensive care unit (ICU). Hospital mortality was twice as high in group A. The older age of group A patients per se did not influence these results significantly. The long-term follow-up was then studied with particular attention to parenchymal functions, hemodynamics, coronary artery disease, metabolic and surgical complications, and survival. The complication rate was higher in group A, with more severe hypertension and higher cholesterol levels at 1 year, a higher prevalence of accelerated coronary artery disease (CAD) and a more frequent onset of insulin-dependent diabetes. Surgical and vascular complications were also more frequent. The final result was a better 5- year actuarial survival rate for group B patients. Donor and recipient ages at the time of transplant did not influence this result. We conclude that ischemic patients, even if they are transplanted in better condition and operated more electively, have a more critical early and long-term postoperative course and a worse survival rate. These findings are not explained by advanced age, but could be due to the impact of atherosclerosis and metabolic impairments associated with ischemic disease.

This article has been cited by other articles:

				M. Cotrufo, L. S. De Santo, A. D. Corte, G. Romano, C. Amarelli, M. De Feo, G. Santarpino, M. Scardone, and G. Nappi Acute hemodynamic and functional effects of surgical ventricular restoration and heart transplantation in patients with ischemic dilated cardiomyopathy. J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1054 - 1060. [Abstract] [Full Text] [PDF]

				M. Cotrufo, G. Romano, L. S. De Santo, A. D. Corte, C. Amarelli, G. Cafarella, C. Maiello, and M. Scardone Treatment of extensive ischemic cardiomyopathy: quality of life following two different surgical strategies Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 481 - 487. [Abstract] [Full Text] [PDF]