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Cerebrovascular syndromes following cardiac transplantation
J C Adair1, G K Call, J B O'Connell
1Department of Neurology, University Hospital, Salt Lake City, UT.
Insights
Cerebrovascular disorders occurred in 24 of 263 heart transplant patients. Stroke causes were often linked to transplant procedures or therapies, but some stemmed from pre-existing vascular conditions.
Area of Science:
- Cardiology
- Neurology
- Transplantation Medicine
Background:
- Orthotopic cardiac transplantation is a life-saving procedure.
- Cerebrovascular disease is a potential complication following major surgery and immunosuppression.
- Understanding stroke risk in heart transplant recipients is crucial for patient management.
Purpose of the Study:
- To determine the incidence of cerebrovascular disease in orthotopic heart transplant recipients.
- To define the clinical spectrum and etiological factors of stroke in this patient population.
Main Methods:
- A retrospective review of 263 patients who underwent 275 orthotopic cardiac transplantations between 1985 and 1990.
- Follow-up averaged 18.5 months to identify and classify cerebrovascular events.
Main Results:
- Cerebrovascular disorders developed in 24 out of 263 patients (9.1%).
- Stroke etiology was directly related to transplant procedures or therapies in 13 cases.
- Nine of the remaining 11 cases (not directly transplant-related) were presumed thromboembolic ischemic events, with some potentially linked to pre-transplant vascular conditions.
Conclusions:
- Cerebrovascular disease is a significant concern in heart transplant recipients.
- Stroke in these patients frequently arises from transplant-related factors, including procedures and therapies.
- Both transplant-specific and pre-existing vascular conditions contribute to stroke risk.
Abstract:
Between 1985 and 1990, there were 275 orthotopic cardiac transplantations performed on 263 patients. To determine the frequency and define the clinical spectrum of cerebrovascular disease among these patients, we followed them over an average period of 18.5 months (range, 1 to 59 months). Cerebrovascular disorders developed in 24 of 263 patients. We established and classified stroke etiology directly related to transplant procedures or therapies in 13 cases. Nine of 11 cases not directly attributable to transplantation had presumed thromboembolic ischemic events. While stroke most commonly results from conditions unique to heart transplant patients, some disorders may develop from vascular conditions that antedate transplantation.