Korean J Thorac Cardiovasc Surg.  1997 Sep;30(9):876-884.

Early Results of the Heart Transplantation for End Stage Heart Failure

• Rho JR
• Won TH
• Lee JR
• Kim KB
• Kim YJ

Abstract

Fourteen patients underwent orthotopic heart transplantation between March 1994 and May 1996 in Seoul National University Hospital. There were 9 male and 5 female patients, and the mean age was 40.8+/-12.4 years ranged from 12 to 56 years. All patient were in NYHA Fc III or IV preoperatively. The underlying heart diseases were dilated cardio- myopathy in 11 and restrictive cardiomyopathy in 3. The mean age of donors was 24.9+/-10.2 years and the causes of the brain death were head trauma by traffic accidents in 8, subarachnoid hemorrhage in 2, 1 asphyxia, 1 fall down injury, 1 brain tumor, and 1 drowning, respectively. The blood type was identical in 11, compatible in 2, and incompatible in 1 patient. The direct bicaval anastomosis technique was used in 11 cases, and standard right atrial anastomosis was done in the remaining 3 cases. The graft ischemic time was 158+/-44 minutes ranged 94 to 220 minutes. There were two hospital deaths(14.3%). The causes of deaths were 1 right ventricular failure followed by suspected cyclosporine induced hemolytic uremic syndrome and rejection, and 1 delayed massive bleeding, probably from rupture of the anastomotic pseudoaneurysm, respectively. The follow-up duration was 16+/-9 months(3 to 28 months). There was one late death(8.3%). All the other patients were in NYHA Fc I except one patient who was in hospital because of the acute rejection. The actuarial survival rates including hospital deaths were 93+/-7% at 1 month, 86+/-9% at 6 months, and 77+/-12% at 2 years. Conclusively, heart transplantation is the good strategy for the management of end stage heart disease with acceptable operative mortality and early follow-up results.

Keyword

Heart transplantation; Cardiomyopathy

MeSH Terms

Accidents, Traffic
Aneurysm, False
Asphyxia
Brain Death
Brain Neoplasms
Cardiomyopathies
Cardiomyopathy, Restrictive
Cause of Death
Craniocerebral Trauma
Cyclosporine
Drowning
Female
Follow-Up Studies
Heart Diseases
Heart Failure*
Heart Transplantation*
Heart*
Hemolytic-Uremic Syndrome
Hemorrhage
Humans
Male
Mortality
Muscular Diseases
Rupture
Seoul
Subarachnoid Hemorrhage
Survival Rate
Tissue Donors
Transplants
Cyclosporine