Reducing neurological complications after cardiac transplantation: Technical considerations

Michael E Jessen, Dan M Meyer, C. L. Moncrief, Michael A Wait, N. B. Melamed, W Steves Ring

Research output: Contribution to journalArticle

3 Scopus citations

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, hypoperfusion 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.

Original languageEnglish (US)
Pages (from-to)546-553
Number of pages8
JournalJournal of Cardiac Surgery
Volume8
Issue number5
Publication statusPublished - 1993

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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