当前位置： SCI文献检索 > TRANSPLANTATION PROCEEDINGS期刊下所有文献 > Hypothermic Circulatory Arrest in Cardiac Transplantation.

Hypothermic Circulatory Arrest in Cardiac Transplantation.

Abstract：

PURPOSE:Infrequently, hypothermic circulatory arrest (HCA) must be used during cardiac transplantation. Such cases may include concomitant aortic arch surgery, explantation of ventricular assist devices with outflow grafts or pseudoaneurysms closely abutting the sternum, and other scenarios for which dense mediastinal adhesions preclude exposure and anatomic dissection by conventional methods of adhesiolysis. Outcomes of heart transplantations performed with HCA have not been previously catalogued in the literature and are presented in the current case series. METHODS:Between November 2012 and December 2014, 193 patients underwent heart transplantation at a single institution. Of these, 7 cases (3.6%) required implementation of HCA. Postoperative outcomes in these patients were analyzed using a prospectively maintained clinical database. RESULTS:The HCA patients included 28% females, with mean age of 46 years, and 71% had nonischemic cardiomyopathies. The majority (N = 5, 71%) had prior ventricular assist device implantation, including 1 patient with a paracorporeal biventricular assist device. One of the remaining 2 patients had three previous surgeries for repair of tetralogy of Fallot, with a completely calcified right ventricular outflow tract and pulmonary arterial system. Mean HCA and cold ischemic times were 25 minutes (range, 9-34 minutes) and 285 minutes (range, 181-425 minutes), respectively. Mean postoperative length of stay was 31 days, and six of seven patients (86%) survived to hospital discharge. One patient expired as an outpatient 2 months following transplant. Rates of postoperative renal failure, respiratory failure, and stroke were 43%, 43%, and 29%, respectively. CONCLUSION:On rare occasions, HCA must be instituted to safely conduct a complex heart transplantation procedure. Based on this small case series, these patients can be salvaged and discharged from the hospital, but may experience prolonged lengths of stay with moderate rates of other end-organ complications.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Lima B,Chamogeorgakis T,MacHannaford JC,Gonzalez-Stawinski GV

doi

10.1016/j.transproceed.2015.07.039

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

2719-21

issue

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(15)00931-8

journal_volume

pub_type

杂志文章

在线工具

Hypothermic Circulatory Arrest in Cardiac Transplantation.