TY - JOUR
T1 - Reducing Neurological Complications After Cardiac Transplantation
T2 - Technical Considerations
AU - Jessen, Michael E
AU - Meyer, Dan M
AU - Moncrief, C. L.
AU - Wait, Michael A
AU - Melamed, N. B.
AU - Ring, W Steves
PY - 1993/9
Y1 - 1993/9
N2 - Abstract As the survival rate for cardiac transplantation improves, attention focuses on morbid events that occur perioperatively. Neurological problems have been recognized after transplantation, and appear to have multiple etiologies including thromboembolism, hypo‐perfusion syndromes, cerebral hemorrhage, and drug toxicities. Since 1988, 113 consecutive adults with end‐stage cardiomyopathy were transplanted using a surgical technique that emphasizes precise everting atrial and great vessel anastomoses, a modified order of anastomoses, continuous endocardial and topical cold irrigation, and careful de‐airing of the heart. Although a significant fraction of the patients were at high risk for cerebral events, the incidence of early and late neurological complications were each under 2%. The rate of early graft dysfunction was low and no patient was found to develop intracardiac thrombus on intermediate‐term follow‐up. These technical modifications may contribute to improved neurological outcomes after transplantation.
AB - Abstract As the survival rate for cardiac transplantation improves, attention focuses on morbid events that occur perioperatively. Neurological problems have been recognized after transplantation, and appear to have multiple etiologies including thromboembolism, hypo‐perfusion syndromes, cerebral hemorrhage, and drug toxicities. Since 1988, 113 consecutive adults with end‐stage cardiomyopathy were transplanted using a surgical technique that emphasizes precise everting atrial and great vessel anastomoses, a modified order of anastomoses, continuous endocardial and topical cold irrigation, and careful de‐airing of the heart. Although a significant fraction of the patients were at high risk for cerebral events, the incidence of early and late neurological complications were each under 2%. The rate of early graft dysfunction was low and no patient was found to develop intracardiac thrombus on intermediate‐term follow‐up. These technical modifications may contribute to improved neurological outcomes after transplantation.
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U2 - 10.1111/j.1540-8191.1993.tb00411.x
DO - 10.1111/j.1540-8191.1993.tb00411.x
M3 - Article
C2 - 8219535
AN - SCOPUS:0027375050
SN - 0886-0440
VL - 8
SP - 546
EP - 553
JO - Journal of Cardiac Surgery
JF - Journal of Cardiac Surgery
IS - 5
ER -