HEART TRANSPLANTATION IN PATIENTS WITH PREVIOUS OPEN HEART SURGERY

Heart Transplantation (HTx) to date remains the most effective and radical method of treatment of patients with end-stage heart failure. The defi cit of donor hearts is forcing to resort increasingly to the use of different longterm mechanical circulatory support systems, including as a «bridge» to the follow-up HTx. According to the ISHLT Registry the number of recipients underwent cardiopulmonary bypass surgery increased from 40% in the period from 2004 to 2008 to 49.6% for the period from 2009 to 2015. HTx performed in repeated patients, on the one hand, involves considerable technical diffi culties and high risks; on the other hand, there is often no alternative medical intervention to HTx, and if not dictated by absolute contradictions the denial of the surgery is equivalent to 100% mortality. This review summarizes the results of a number of published studies aimed at understanding the immediate and late results of HTx in patients, previously underwent open heart surgery. The effect of resternotomy during HTx and that of the specifi c features associated with its implementation in recipients previously operated on open heart, and its effects on the immediate and long-term survival were considered in this review. Results of studies analyzing the risk factors for perioperative complications in repeated recipients were also demonstrated. Separately, HTx risks after implantation of prolonged mechanical circulatory support systems were examined. The literature does not allow to clearly defi ning the impact factor of earlier performed open heart surgery on the course of perioperative period and on the prognosis of survival in recipients who underwent HTx. On the other hand, subject to the regular fl ow of HTx and the perioperative period the risks in this clinical situation are justifi ed as a long-term prognosis of recipients previously conducted open heart surgery and are comparable to those of patients who underwent primary HTx. Studies cited in the review may have important clinical applications, because they outline the range of problems and possible solutions in the performance of the HTx in recipients previously operated on open heart. This knowledge can facilitate the decision making process with regard to the opportunities and risks of the implementation of HTx. Given the uniqueness of each of the recipient and the donor, it is required to make a personalized approach to the question of the possible risks and to the preventive measures to reduce those risks in any given clinical situation.

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Open heart surgery and repair of complex abdominal aortic aneurysms – early and long-term results of a simultaneous approach

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2007-967411 ◽

2007 ◽

Vol 55 (S 1) ◽

Author(s):

A Rastan ◽

M Luduena ◽

R Battelini ◽

T Walther ◽

J Kempfert ◽

...

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Long Term Results ◽

Open Heart ◽

Simultaneous Approach ◽

Abdominal Aortic

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Long-term management of bradyarrhythmias following open heart surgery: Surgical A-V block and sick sinus syndrome after surgery for secundum atrial septal defects treated with permanent cardiac pacing.

Japanese Circulation Journal ◽

10.1253/jcj.50.903 ◽

1986 ◽

Vol 50 (9) ◽

pp. 903-917 ◽

Cited By ~ 4

Author(s):

Satoshi OHNISHI ◽

Hiroshi KASANUKI ◽

Kunitake TAKAMIZAWA ◽

Atsuyoshi TAKAO ◽

Koshichiro HIROSAWA

Keyword(s):

Heart Surgery ◽

Sick Sinus Syndrome ◽

Open Heart Surgery ◽

Cardiac Pacing ◽

Open Heart ◽

Septal Defects ◽

Atrial Septal Defects ◽

Term Management

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Short and Long-term Results of Open Heart Surgery in Aortic Valve Disease

Korean Circulation Journal ◽

10.4070/kcj.1998.28.9.1509 ◽

1998 ◽

Vol 28 (9) ◽

pp. 1509 ◽

Cited By ~ 1

Author(s):

Hyun-Sook Kim ◽

Jae-Kwan Song ◽

Jae-Hwan Lee ◽

Young-Hak Kim ◽

Min-Kyu Kim ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Disease ◽

Heart Surgery ◽

Open Heart Surgery ◽

Valve Disease ◽

Long Term Results ◽

Open Heart ◽

Short And Long Term

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P1836Constrictive pericarditis after open heart surgery: a 20-year case controlled study

European Heart Journal ◽

10.1093/eurheartj/ehz748.0588 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A E Moreyra ◽

Y Yang ◽

S Zinonos ◽

N M Cosgrove ◽

J Cabrera ◽

...

Keyword(s):

Constrictive Pericarditis ◽

Heart Surgery ◽

Rare Complication ◽

Open Heart Surgery ◽

Controlled Study ◽

Robert Wood Johnson Foundation ◽

Open Heart ◽

Significant Difference ◽

Long Term Prognosis

Abstract Background Constrictive pericarditis (CoPe) after open-heart surgery (OHS) is a rare complication. Information on the incidence, determinants, and prognosis of this condition has been scarcely reported. Purpose To investigate the long term prognosis of CoPe after OHS. Methods Using the Myocardial Infarction Data Acquisition System database, we analyzed records of 144,902 patients that had OHS in New Jersey hospitals between 1995 and 2015. CoPe was identified in 79 patients after discharge. Differences in proportions were analyzed using chi square. Cases and controls were matched for demographics and comorbidities. Cox proportional hazard models were used to evaluate outcome risks. Log-rank test was used to assess differences in the Kaplan-Meier survival curves. Results Patients with CoPe were more likely to have history of valve disease (HVD) (p<0.0001), atrial fibrillation (AF) (p=0.0006) and chronic kidney disease (CKD) (p=0.012). Significant predictors of CoPe were AF (HR 1.62, 95% CI 1.02–2.59), CKD (HR 2.70, 95% CI 1.53–4.76), diabetes (HR 1.73, 95% CI 1.08–2.80) and HVD (HR 3.11, 95% CI 1.88–5.15). Patients with CoPe compared to matched controls had a higher 10-year mortality (p<0.0001). This became a statistically significant difference at 6 years after surgery (Figure). Survival Curve Conclusion Constrictive pericarditis is a rare complication of OHS and occurs more frequently in patients with AF, CKD, diabetes and HVD. It is associated with an unfavorable long-term prognosis. The data highlight the need for strategies to help prevent this complication. Acknowledgement/Funding Robert Wood Johnson Foundation

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The Effects of Norepinephrine Infusion on the Circulating Lymphocyte Counts of Post–Open Heart Surgery Patients

Biological Research For Nursing ◽

10.1177/109980040000100305 ◽

2000 ◽

Vol 1 (3) ◽

pp. 199-209

Author(s):

Wanda Zziwambazza ◽

Carrie J. Merkle ◽

Ida M. Moore ◽

Jean Davis

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

The Other ◽

Open Heart ◽

Postoperative Infections ◽

Norepinephrine Infusion ◽

Beta Blocking ◽

Group 3 ◽

Group 2 ◽

Group 1

In this retrospective study employing chart reviews, 75 open heart surgery patients (OHSPs) were divided into 3 groups of 25 patients. Group 1 received no intravenous (IV) norepinephrine (NE) after surgery. Group 2 and group 3 received a minimum of 0.028 mcg/kg/min of IV NE for 6-24 h and greater than 24 h, respectively. In the 3 groups, preoperative lymphocyte counts were compared to counts obtained on postoperative days 1 and 2. The results showed lower lymphocyte counts on postoperative day 2 in group 3 subjects, who received NE for 24 h or more, compared to subjects of the other groups who received no NE or 6-24 h of NE (p < 0.05). There was also evidence that preoperative use of beta-blocking agents significantly affected the change in lymphocyte counts from day 1 to day 2 in both groups receiving NE. Furthermore, postoperative infections were more prevalent in group 3 than the other 2 groups (p < 0.05). The lower lymphocyte counts and higher infection rate, however, may be linked to lower postoperative blood pressure and increased number of intensive care unit days in group 3. Further investigation is warranted to elucidate the effects of IV NE administration on the lymphocyte counts of OHSPs and to reduce infections in those receiving NE.

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Continuous, Long-Term Measurement of Cardiac Output after Open-Heart Surgery

Annals of Surgery ◽

10.1097/00000658-197109000-00004 ◽

1971 ◽

Vol 174 (3) ◽

pp. 357-363 ◽

Cited By ~ 10

Author(s):

Bryn T. Williams ◽

S. Sancho-Fornos ◽

D. B. Clarke ◽

L. D. Abrams ◽

Worthington G. Schenk

Keyword(s):

Cardiac Output ◽

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Long Term Measurement

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SHORT- AND LONG-TERM OUTCOMES OF THREE APPROACHES TO CAROTID REVASCULARIZATION AMONG PATIENTS REQUIRING OPEN HEART SURGERY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(11)61579-9 ◽

2011 ◽

Vol 57 (14) ◽

pp. E1579

Author(s):

Sridhar Venkatachalam ◽

Samir R. Kapadia ◽

Heather L. Gornik ◽

Penny Houghtaling ◽

Zhiyuan Sun ◽

...

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Long Term Outcomes ◽

Carotid Revascularization ◽

Short And Long Term

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Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Stroke ◽

10.1161/01.str.17.3.410 ◽

1986 ◽

Vol 17 (3) ◽

pp. 410-416 ◽

Cited By ~ 144

Author(s):

K A Sotaniemi ◽

H Mononen ◽

T E Hokkanen

Keyword(s):

Heart Surgery ◽

Open Heart Surgery ◽

Open Heart ◽

Follow Up Study

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Cardiac Troponin T for Prediction of Short- and Long-Term Morbidity and Mortality after Elective Open Heart Surgery

Clinical Chemistry ◽

10.1373/clinchem.2004.031468 ◽

2004 ◽

Vol 50 (9) ◽

pp. 1560-1567 ◽

Cited By ~ 85

Author(s):

Stephanie Lehrke ◽

Henning Steen ◽

Hans H Sievers ◽

Hanno Peters ◽

Armin Opitz ◽

...

Keyword(s):

Heart Surgery ◽

Cell Injury ◽

Troponin T ◽

Open Heart Surgery ◽

Cleveland Clinic ◽

Myocardial Cell ◽

Risk Indicators ◽

Open Heart ◽

Cardiac Mortality

Abstract Background: Increased cardiac troponins in blood are observed after virtually every open heart surgery, indicating perioperative myocardial cell injury. We sought to determine the optimum time point for blood sampling and the respective cutoff value of cardiac troponin T (cTnT) for risk assessment in patients undergoing cardiac surgery. Methods: In a series of 204 patients undergoing scheduled open heart surgery, mainly for coronary artery bypass grafting (n = 132) or valve repair (n = 27), cTnT concentrations were measured before and 4 and 8 h after cross-clamping and then daily for 7 days. Individual risk was assessed by use of the Cleveland Clinic Foundation Risk score and intraoperative risk indicators such as duration of cardiopulmonary bypass, cross-clamping, and perioperative release of cardiac markers. Patients were followed for 28 months. Results: Cardiac mortality, all-cause mortality rates, and rates of nonfatal acute myocardial infarction (AMI) at 28 months were 6.9%, 8.8%, and 6.8%, respectively. cTnT was higher in patients with Q-wave AMI or postoperative heart failure requiring inotropic support, and in nonsurvivors. The ROC curve revealed a cTnT ≥0.46 μg/L at 48 h as the optimum discriminator for long-term cardiac mortality. Stepwise logistic regression identified higher Cleveland Clinic Risk Score [odds ratio (OR) = 2.6 per point], cross-clamp time >65 min (OR = 6.6), and cTnT (OR = 4.9) as significant and independent predictors of long-term cardiac mortality. Conclusions: A single postoperative cTnT measurement can be used to estimate myocardial cell injury that impacts long-term survival after open heart surgery. It adds independently to established risk indicators.

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