Indications, Complications, and Outcomes of Cardiac Surgery After Heart Transplantation : Results From the Cash Study
Gökler, Johannes (Medical University of Vienna)
Aliabadi-Zuckermann, Arezu Z. (Medical University of Vienna)
Kaider, Alexandra (Medical University of Vienna)
Ambardekar, Amrut V. (University of Colorado School of Medicine)
Antretter, Herwig (Medical University Innsbruck)
Artemiou, Panagiotis (Medical Faculty of the Comenius University)
Bertolotti, Alejandro M. (Favaloro Foundation University Hospital)
Boeken, Udo (Heinrich Heine University Hospital)
Brossa Loidi, Vicens (Institut d'Investigació Biomèdica Sant Pau)
Copeland, Hannah (Indiana University School of Medicine)
Generosa Crespo-Leiro, Maria (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Eixeré-Esteve, Andrea (Hospital 12 de Octubre (Madrid))
Epailly, Eric (Les Hôpitaux Universitaires NHC)
Farag, Mina (Heidelberg University Hospital (Alemanya))
Hulman, Michal (Medical Faculty of the Comenius University)
Khush, Kiran K. (Stanford University School of Medicine)
Masetti, Marco (Policlinico Sant'Orsola-Malpighi (Bolònia, Itàlia))
Patel, Jignesh (Cedars-Sinai Medical Center)
Ross, Heather J. (Peter Munk Cardiac Centre)
Rudež, Igor (University Hospital Dubrava)
Silvestry, Scott (AdventHealth Transplant Institute)
Suarez, Sofia Martin (Policlinico Sant'Orsola-Malpighi (Bolònia, Itàlia))
Vest, Amanda (Tufts Medical Center)
Zuckermann, Andreas O. (Medical University of Vienna)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Allograft pathologies, such as valvular, coronary artery, or aortic disease, may occur early and late after cardiac transplantation. Cardiac surgery after heart transplantation (CASH) may be an option to improve quality of life and allograft function and prolong survival. Experience with CASH, however, has been limited to single-center reports. We performed a retrospective, multicenter study of heart transplant recipients with CASH between January 1984 and December 2020. In this study, 60 high-volume cardiac transplant centers were invited to participate. Data were available from 19 centers in North America (n = 7), South America (n = 1), and Europe (n = 11), with a total of 110 patients. A median of 3 (IQR 2-8. 5) operations was reported by each center; five centers included ≥ 10 patients. Indications for CASH were valvular disease (n = 62), coronary artery disease (CAD) (n = 16), constrictive pericarditis (n = 17), aortic pathology (n = 13), and myxoma (n = 2). The median age at CASH was 57. 7 (47. 8-63. 1) years, with a median time from transplant to CASH of 4. 4 (1-9. 6) years. Reoperation within the first year after transplantation was performed in 24. 5%. In-hospital mortality was 9. 1% (n = 10). 1-year survival was 86. 2% and median follow-up was 8. 2 (3. 8-14. 6) years. The most frequent perioperative complications were acute kidney injury and bleeding revision in 18 and 9. 1%, respectively. Cardiac surgery after heart transplantation has low in-hospital mortality and postoperative complications in carefully selected patients. The incidence and type of CASH vary between international centers. Risk factors for the worse outcome are higher European System for Cardiac Operative Risk Evaluation (EuroSCORE II) and postoperative renal failure.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Cardiac retransplantation ; Cardiac surgery ; Cardiac transplantation ; Heart failure ; Heart transplantation
Publicat a:	Frontiers in Cardiovascular Medicine, Vol. 10 (june 2022) , ISSN 2297-055X

DOI: 10.3389/fcvm.2022.879612
PMID: 35756840

12 p, 1.7 MB

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