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A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
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Outcomes in patients with solid organ transplants undergoing cardiac surgery
Valentino Bianco1, Arman Kilic2, Thomas G Gleason2
1Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa.
The Journal of Thoracic and Cardiovascular Surgery
|October 1, 2019
Summary
Cardiac surgery in solid organ transplant recipients shows low operative mortality but high 5-year readmission rates, especially after valve procedures. Long-term survival is achievable, but managing post-operative care is crucial.
Area of Science:
- Cardiology
- Transplant Surgery
- Outcomes Research
Background:
- Outcomes after cardiac surgery in solid organ transplant recipients (SOTR) are not well-documented.
- Evaluating long-term results is essential for this growing patient population.
Purpose of the Study:
- To assess postoperative outcomes in SOTR undergoing cardiac surgery.
- To identify factors associated with mortality and readmissions.
Main Methods:
- Retrospective review of adult patients undergoing isolated coronary artery bypass grafting (CABG), isolated valve surgery, or combined CABG + valve surgery from 2011-2018.
- Included patients with SOTs.
- Primary outcomes: 30-day and 5-year mortality and readmissions.
Main Results:
- 129 SOTR (1%) out of 11,190 patients were identified.
- Operative mortality was 2%.
- 5-year mortality was associated with chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF).
- 5-year readmission rate was 88%, associated with COPD, dialysis dependence, and valve surgery.
- Valve procedures had significantly lower freedom from readmission.
Conclusions:
- Cardiac surgery is feasible in SOTR with low operative mortality and good long-term survival.
- High rates of 5-year hospital readmissions are observed, particularly following valve operations.
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