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8 records – page 1 of 1.

Analysis of deaths after heart transplantation: the University of Ottawa Heart Institute experience.

https://arctichealth.org/en/permalink/ahliterature220432
Source
J Heart Lung Transplant. 1993 Sep-Oct;12(5):790-801
Publication Type
Article
Author
V M Walley
R G Masters
S A Boone
A L Wolfsohn
R A Davies
P J Hendry
W J Keon
Author Affiliation
Department of Pathology, University of Ottawa, Ontario, Canada.
Source
J Heart Lung Transplant. 1993 Sep-Oct;12(5):790-801
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anastomosis, Surgical - adverse effects - statistics & numerical data
Assisted Circulation - statistics & numerical data
Cause of Death
Child
Child, Preschool
Female
Forecasting
Heart Diseases - pathology - physiopathology
Heart Transplantation - adverse effects - mortality - pathology
Heart, Artificial - statistics & numerical data
Hospital Mortality
Humans
Infant
Infant, Newborn
Male
Middle Aged
Ontario - epidemiology
Reoperation
Risk factors
Survival Rate
Tissue Donors - statistics & numerical data
Abstract
This study reviews the clinical outcome of the 132 orthotopic heart transplantations performed at our institute from 1984 through 1991 and focuses on the pathology of those patients who died. The study comprised 124 adults (mean age, 45.6 +/- 0.9 years) and eight children. Twenty-six adult and one pediatric deaths occurred. Operative mortality (within 30 days) was 10.6%, with 84.8% of patients surviving to discharge. Actuarial probabilities of survival at 1 and 5 years were 84% +/- 3% and 71% +/- 6%, respectively. Of the 27 deaths, six (22.2%) occurred in the operating room (from hemorrhage, graft failure, and hyperacute rejection); 14 (51.9%) occurred in-hospital after surgery (from sepsis, rejection, cytomegalovirus disease, or myocardial infarct), and seven (25.9%) occurred after discharge (from rejection and/or recurrent coronary artery disease). Two groups of patients were at higher risk: patients in cardiogenic shock requiring pretransplantation mechanical support, with in-hospital mortality of 39.1%; and patients with previous valve replacement who were taking oral anticoagulants, with intraoperative mortality of 50.0%. Pathologic examination revealed occasional instances of unsuspected coronary artery disease in the donor hearts with more than 50% stenoses of the left anterior descending coronary arteries in three of 21 (14.3%) of cases. Complications of the transplantation or related therapeutic procedures were common among those who died. The complications ranged from functionally insignificant anatomic curiosities to life-threatening problems. These complications are tabulated and shown.
PubMed ID
8241216 View in PubMed
Less detail

Cardiac transplantation after mechanical circulatory support: a Canadian perspective.

https://arctichealth.org/en/permalink/ahliterature211824
Source
Ann Thorac Surg. 1996 Jun;61(6):1734-9
Publication Type
Article
Date
Jun-1996
Author
R G Masters
P J Hendry
R A Davies
S. Smith
C. Struthers
V M Walley
J P Veinot
T V Mussivand
W J Keon
Author Affiliation
Division of Surgery, University of Ottawa Heart Institute, Ottawa Civic Hospital, Ontario, Canada.
Source
Ann Thorac Surg. 1996 Jun;61(6):1734-9
Date
Jun-1996
Language
English
Publication Type
Article
Keywords
Administration, Oral
Adult
Assisted Circulation - adverse effects
Cardiotonic Agents - administration & dosage - therapeutic use
Coronary Disease - surgery
Female
Follow-Up Studies
Graft Rejection - etiology
Heart Transplantation - adverse effects
Heart, Artificial
Heart-Assist Devices
Humans
Injections, Intravenous
Intra-Aortic Balloon Pumping - instrumentation
Life tables
Male
Middle Aged
Ontario
Patient Discharge
Prospective Studies
Shock, Cardiogenic - surgery
Surgical Wound Infection - etiology
Survival Rate
Abstract
To assess the relative efficacy of cardiac transplantation after mechanical circulatory support with a variety of support systems, we analyzed our consecutive series of patients who had and did not have mechanical support before transplantation.
A review of 209 patients undergoing cardiac transplantation from 1984 to May 1995 was performed. Group 1 consisted of 110 patients who were maintained on oral medications while awaiting transplantation, and group 2 consisted of 60 patients who required intravenous inotropic support. Group 3 included 39 patients who had transplantation after mechanical circulatory support for cardiogenic shock. The indication for device implantation was acute onset of cardiogenic shock in 38 patients and deterioration while awaiting transplantation in 1 patient. The support systems were an intraaortic balloon pump in 13 (subgroup 3A), a ventricular assist device in 7 (subgroup 3B), and a total artificial heart in 19 patients (subgroup 3C).
After transplantation, infection was more common in group 3 (56%) than in group 1 (28%) or group 2 (32%) (p = 0.005). Survival to discharge was lower for group 3 (71.7%) than for group 1 (90.9%) or 2 (88.3%) (p = 0.009). For mechanically supported patients, survival to discharge was 84.6% in subgroup 3A, 71.4% in subgroup 3B, and 63.1% in subgroup 3C (p = not significant).
Transplantation after mechanical support offers acceptable results in this group of patients for whom the only alternative is certain death. Patient selection and perioperative management remain the challenge to improving these results.
PubMed ID
8651776 View in PubMed
Less detail

[Circulatory support with the mechanical heart, "HeartMate"]

https://arctichealth.org/en/permalink/ahliterature54059
Source
Ugeskr Laeger. 2000 Jun 26;162(26):3717-22
Publication Type
Article
Date
Jun-26-2000
Author
K M Sander Jensen
J. Aldershvile
S. Boesgaard
P B Hansen
A M Kjersem
A. Kolbye
S A Mortensen
K S Nielsen
P S Olsen
B. Rasmussen
G. Vogelsang
Author Affiliation
H:S Rigshospitalet, Hjertecentret.
Source
Ugeskr Laeger. 2000 Jun 26;162(26):3717-22
Date
Jun-26-2000
Language
Danish
Publication Type
Article
Keywords
Assisted Circulation - instrumentation - methods - trends
Counterpulsation - instrumentation - methods - trends
English Abstract
Heart Failure, Congestive - diagnosis - surgery - therapy
Heart, Artificial - adverse effects - trends
Heart-Assist Devices - adverse effects - trends
Humans
Medical Illustration
Abstract
Treatment with the mechanical heart, HeartMate, has been introduced in Denmark. Short-term circulatory support can be obtained by intraaortic balloon counterpulsation, an external centrifugal pump and the total artificial heart. Long-term circulatory support can be established by treatment with the HeartMate. The principle of the mechanical heart is simple--a pump is implanted in parallel to the existing heart and connected to external, portable batteries. The patient quickly improves and is brought in an optimal state for transplantation. A few patients have been able to omit the subsequent heart transplantation. The patient's own heart improved during the treatment and the native heart functioned again after the system was explanted. The main complications during treatment are bleeding, infection, thromboembolic events and systemic failure. Permanent, fully implantable mechanical circulatory pumps are under development--which may herald the beginning of a whole new era for treatment of cardiac failure.
PubMed ID
10925631 View in PubMed
Less detail

[Economic aspects of implementation of the mechanical heart, "HeartMate"]

https://arctichealth.org/en/permalink/ahliterature54058
Source
Ugeskr Laeger. 2000 Jun 26;162(26):3722-5
Publication Type
Article
Date
Jun-26-2000
Author
A. Kolbye
K M Sander Jensen
J. Aldershvile
P B Hansen
A M Kjersem
K S Nielsen
P S Olsen
B. Rasmussen
G. Vogelsang
Author Affiliation
H:S Rigshospitalet, Hjertecentret.
Source
Ugeskr Laeger. 2000 Jun 26;162(26):3722-5
Date
Jun-26-2000
Language
Danish
Publication Type
Article
Keywords
Cost-Benefit Analysis
Denmark - epidemiology
English Abstract
Heart Failure, Congestive - economics - mortality - surgery - therapy
Heart Transplantation - economics
Heart, Artificial - economics
Heart-Assist Devices - economics
Humans
Models, Economic
Survival Rate
Technology Assessment, Biomedical - economics
Value of Life
Abstract
This economic evaluation was performed to assess the economic consequences for society and for the Danish health care sector of replacing the traditional treatment with Biomedicus assist device with The Mechanical Heart, HeartMate, as a bridge to transplantation for patients with severe cardiac failure. A cost-effectiveness analysis showed that the use of HeartMate is more cost-effective than the use of Biomedicus assist device. Using HeartMate one life-year gained costs DKK 225,000. Using Biomedicus one life-year gained costs DKK 270,000. The use of HeartMate results in an additional expenditure of DKK 615,000 per patient. By this additional expenditure the patients gain 3.6 extra life-years on average. The marginal expenditure by replacing the Biomedicus treatment with HeartMate is DKK 170,000 per extra life-year gained.
PubMed ID
10925632 View in PubMed
Less detail

Heart transplants likely to quadruple in Canada by 1990.

https://arctichealth.org/en/permalink/ahliterature236839
Source
Can J Surg. 1986 Jul;29(4):230-2
Publication Type
Article
Date
Jul-1986

STUDIES OF THE EPIDEMIOLOGY OF STAPHYLOCOCCAL INFECTIONS. II. STAPHYLOCOCCAL INFECTIONS IN A THORACIC SURGERY UNIT.

https://arctichealth.org/en/permalink/ahliterature57346
Source
Acta Chir Scand. 1964 Oct;128:421-34
Publication Type
Article
Date
Oct-1964

8 records – page 1 of 1.