Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Systemic embolism: a serious complication after cardiac transplantation avoidable by bicaval technique
Autore:
Riberi, A; Ambrosi, P; Habib, G; Kreitmann, B; Yao, JG; Gaudart, J; Ghez, O; Metras, D;
Indirizzi:
Childrens Hosp la Timone, Dept Cardiovasc Surg, F-13385 Marseille 5, France Childrens Hosp la Timone Marseille France 5 F-13385 Marseille 5, France La Timone Hosp, Dept Cardiol, F-13385 Marseille, France La Timone Hosp Marseille France F-13385 rdiol, F-13385 Marseille, France La Timone Hosp, Dept Med Informat, F-13385 Marseille 5, France La Timone Hosp Marseille France 5 Informat, F-13385 Marseille 5, France
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 3, volume: 19, anno: 2001,
pagine: 307 - 311
SICI:
1010-7940(200103)19:3<307:SEASCA>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSESOPHAGEAL ECHOCARDIOGRAPHIC FINDINGS; ORTHOTOPIC HEART-TRANSPLANTATION; PREVALENCE; THROMBI;
Keywords:
cardiac transplantation; atrial; thrombosis; systemic embolism;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Riberi, A Childrens Hosp la Timone, Dept Cardiovasc Surg, Rue Armee Afrique, F-13385Marseille 5, France Childrens Hosp la Timone Rue Armee Afrique Marseille France 5 e
Citazione:
A. Riberi et al., "Systemic embolism: a serious complication after cardiac transplantation avoidable by bicaval technique", EUR J CAR-T, 19(3), 2001, pp. 307-311

Abstract

Objective: Systemic embolism is a serious complication after classical orthotopic transplantation, presumably originating from enlarged left atrium. We specifically studied this problem after classical and modified bicaval transplantation. Methods: Between December 1985 and March 1999 we consecutively performed 72 classical and 106 modified heart transplantation. Modification included bicaval anastomosis and recipient left atrium maximal reduction. Mean age was 47 years. All the patients received an antiplatelet therapy and were routinely followed. When clinical signs of systemic embolism were present, a neurological evaluation and transesophageal echocardiography were done. Sixty matched patients (30 of each group) had comparative transesophageal echocardiography study, at least 6 months after transplantation. Results: Perioperative mortality was 17.4%. Mean follow-up was 6.82 + /47 years. All patients were in sinus rhythm. Among 147 survivors, 11 patients who underwent classical transplantation had a systemic embolism, 1 month to 12 years after transplantation, 15.3%, (11/72). Two limb ischemia and one mesenteric ischemia (needing surgery), seven strokes (one death, two permanent neurological deficit). There was no systemic embolism in the modified technique group (P = 0.013). Left atrial comparative transesophageal echocardiography study showed a larger left atrial surface in classical transplantation. 33 +/- 4 cm(2) versus 20 +/- 3 cm(2) in a modified technique, P = 0.01. Spontaneous echo contrast was present in 56% of classical technique groupassociated with atrial thrombosis in nine patients, there were no atrial thrombosis in modified technique group and spontaneous echocontrast was present in 0.5% (P = <0.001). Conclusion: The occurrence of systemic embolism, left atrial spontaneous echocontrast and thrombosis when using classical technique, and the absence of these complications with the bicaval technique justified the use of this method. Our experience with atrial thrombosis andspontaneous echocontrast rises the question of anticoagulation in classical transplantation. <(c)> 2001 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 05:53:58