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Abdominal aortic aneurysmectomy in long-term cardiac transplant survivors
Insights
Heart transplant recipients with atherosclerotic disease face risks of abdominal aortic aneurysms. Long-term survivors require surveillance for other atherosclerotic complications.
Area of Science:
- Cardiology
- Transplantation Immunology
- Vascular Surgery
Background:
- Atherosclerotic disease is common in heart transplant candidates.
- Heart transplantation aims to improve survival in end-stage heart failure.
Observation:
- Two-thirds of 114 heart transplant patients had pre-existing atherosclerotic cardiac disease.
- Two patients developed symptomatic abdominal aortic aneurysms post-transplant.
Findings:
- Successful surgical resection of abdominal aortic aneurysms was achieved in these two patients.
- Management focused on infection prophylaxis and hemodynamic, metabolic, and immune stability.
Implications:
- Long-term surveillance of cardiac transplant survivors is crucial for detecting other atherosclerotic manifestations.
- Atherosclerotic disease poses a significant long-term risk in heart transplant recipients.
Abstract:
Two thirds of the 114 patients undergoing heart transplantation at Stanford (Calif) Medical Center have had atherosclerotic cardiac disease. Two of these patients have been found in the late posttransplant period to have symptomatic abdominal aortic aneurysms requiring resection. We present the clinical course and successful operative treatment of these two patients, with emphasis on the prophylaxis of infection and maintenance of hemodynamic, metabolic, and immune stability. Close surveillance of the long-term cardiac transplant survivor should be directed towards other manifestations of atheroscleortic disease.