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Cardiac transplantation in New Zealand: eight years experience
M Lund1, C J Ellis, H A Coverdale
1Department of Cardiology, Green Lane Hospital, Epsom, Auckland.
Insights
Cardiac transplantation offers a valuable treatment for end-stage heart failure, significantly improving functional class in survivors. This study shows promising survival rates for patients undergoing this procedure.
Area of Science:
- Cardiology
- Cardiac Surgery
- Transplantation Medicine
Background:
- End-stage heart dysfunction significantly impacts patient quality of life.
- Orthotopic cardiac transplantation is a treatment option for severe heart failure.
- Common causes include dilated cardiomyopathy and coronary artery disease.
Purpose of the Study:
- To evaluate the outcomes of orthotopic cardiac transplantation.
- To assess survival rates and functional status post-transplantation.
- To determine the role of cardiac transplantation in managing end-stage myocardial dysfunction.
Main Methods:
- Retrospective analysis of 62 patients undergoing orthotopic cardiac transplantation.
- Data collected between December 1987 and December 1995.
- Assessment of perioperative mortality, long-term survival, and functional class (New York Heart Association).
Main Results:
- Perioperative mortality was 13% (8 patients), with an additional 11% (7 patients) dying within 1-4 years.
- Actuarial 1-year and 3-year survival rates were 87% and 80%, respectively.
- Of 47 survivors, 45 achieved New York Heart Association functional class I.
Conclusions:
- Cardiac transplantation is a valuable, albeit limited, treatment for end-stage myocardial dysfunction.
- The procedure can lead to significant functional improvement in surviving patients.
- Long-term survival rates support its role in selected heart failure patients.
Abstract:
Between December 1987 and December 1995, 62 patients underwent orthotopic cardiac transplantation at Green Lane Hospital. Their cardiac dysfunction resulted from dilated cardiomyopathy (32), coronary artery disease (21), rheumatic heart disease (7), congenitally corrected transposition of the great arteries (1) and hypertrophic cardiomyopathy (1). Before transplantation all patients were in New York Heart Association (NYHA) functional class III or IV. Eight patients (13%) died in the perioperative period and a further seven (11%) died 1 to 4 years after transplantation. Actuarial 1 and 3 year survival was 87% and 80% respectively. Forty-five of forty-seven surviving patients were in NYHA functional class I at the time of analysis. The results confirm that cardiac transplantation has a limited but valuable role in the treatment of end stage myocardial dysfunction.