Abstract:Houve predomínio do sexo masculino em 70% dos casos e a idade variou de 7 a 69 anos, com média de 44,8 anos. Doze (15%) pacientes se encontravam em prioridade, em uso de drogas inotrópicas endovenosas no momento do transplante. As etiologias determinantes da insuficiência cardíaca congestiva grave foram: miocardiopatia dilatada idiopática em 37,5%, miocardiopatia isquêmica em 33,75%, miocardiopatia chagásica em 17,5% e outras causas em 11,25%. Foram realizados 78 transplantes ortotópicos e 2 heterotópicos. A t… Show more
“…The importance of our findings is to demonstrate the safety of the myocardial protection technique during explant and type of cardioplegia during implantation of the graft in this series and clinical outcomes in short-and long-term follow-up. Our results are generally comparable to the literature [14,15].…”
Section: Discussionsupporting
confidence: 91%
“…Our overall late survival was 74% and 60% after 1 year and 5 years, respectively, rates similar to those described in the national literature [14,15].…”
Section: Discussionsupporting
confidence: 89%
“…The hospital mortality was low (11%) and comparable to data from the national literature [14,15]. Late complications were related to infection not being detected cases of organ failure or allograft vasculopathy.…”
Section: Discussionsupporting
confidence: 78%
“…The same happened to aortic clamping. We should note that the duration of cardiopulmonary bypass is very similar to that described in the literature [14,15]. The clamping time was relatively short (average 66 minutes), which may have contributed to the outcome of this series.…”
Fatores associados à sobrevida em pacientes submetidos a transplante cardíaco utilizando microcardioplegia sanguínea retrógrada Associated factors with survivals in patients undergoing orthotopic heart transplant using retrograde blood microcardioplegia Abstract Background: Several techniques and cardioplegic solutions have been used for heart preservation during transplant procedures. Unfortunately, there is a lack of ideal method for myocardial preservation in the clinical practice. The use of retrograde cardioplegia provides continuous infusion of cardioplegic solution during the graft implantation. This strategy may provide better initial recovery of the graft. The objective of this study is to describe the experience of a single center where all patients received the same solution for organ preservation and were subjected to continuous retrograde blood microcardioplegia during implantation of the graft and to evaluate factors associated to early and late mortality with this technique.Methods: This is a retrospective, observational and descriptive study of a single center.Results: During the study period were performed 35 heart transplants. Fifteen (42.9%) patients were in cardiogenic shock. The probability of survival was 74.8±7.8%, 60.4±11.3% and 15.1±13.4% at 1 year, 5 years and 10 years of follow-up, respectively. The median survival time was 96.6 months.Conclusion: The use of myocardial protection with retrograde cardioplegic solution may reduce the risks associated morbidity due to cold ischemia time during the heart transplant, and we suggest that this benefit may be even greater in cases of cold ischemia time longer ensuring protection to the myocardium.Descriptors: Heart transplantation. Transplantation. Heart arrest, induced. Myocardium. Follow-up studies.
ResumoIntrodução: Uma grande variedade de técnicas e soluções é utilizada na preservação do coração durante o transplante, o que demonstra a falta de método ideal na prática clínica. A
348Lavagnoli CFR, et al. -Associated factors with survivals in patients undergoing orthotopic heart transplant using retrograde blood microcardioplegia Bras Cir Cardiovasc 2012;27(3):347-54 INTRODUCTION A variety of techniques and solutions are used in the preservation of the heart during transplantation, demonstrating the lack of ideal method in clinical practice [1].
RevIn the present day, where the number of donors is not enough, in addition to the increase of high-risk recipients on the waiting list, every effort should be made towards better organ preservation. A better organ preservation leads to lower graft dysfunction and promotes better late outcomes after transplantation [2,3].The use of retrograde blood cardioplegia has been described in several studies in the literature. There is no consensus whether this strategy promotes adequate myocardial protection [4]. Its use for the administration of blood cardioplegia during implantation is frequently reported in the literature. This strategy of cardioplegia administration allows for continuous perfusion o...
“…The importance of our findings is to demonstrate the safety of the myocardial protection technique during explant and type of cardioplegia during implantation of the graft in this series and clinical outcomes in short-and long-term follow-up. Our results are generally comparable to the literature [14,15].…”
Section: Discussionsupporting
confidence: 91%
“…Our overall late survival was 74% and 60% after 1 year and 5 years, respectively, rates similar to those described in the national literature [14,15].…”
Section: Discussionsupporting
confidence: 89%
“…The hospital mortality was low (11%) and comparable to data from the national literature [14,15]. Late complications were related to infection not being detected cases of organ failure or allograft vasculopathy.…”
Section: Discussionsupporting
confidence: 78%
“…The same happened to aortic clamping. We should note that the duration of cardiopulmonary bypass is very similar to that described in the literature [14,15]. The clamping time was relatively short (average 66 minutes), which may have contributed to the outcome of this series.…”
Fatores associados à sobrevida em pacientes submetidos a transplante cardíaco utilizando microcardioplegia sanguínea retrógrada Associated factors with survivals in patients undergoing orthotopic heart transplant using retrograde blood microcardioplegia Abstract Background: Several techniques and cardioplegic solutions have been used for heart preservation during transplant procedures. Unfortunately, there is a lack of ideal method for myocardial preservation in the clinical practice. The use of retrograde cardioplegia provides continuous infusion of cardioplegic solution during the graft implantation. This strategy may provide better initial recovery of the graft. The objective of this study is to describe the experience of a single center where all patients received the same solution for organ preservation and were subjected to continuous retrograde blood microcardioplegia during implantation of the graft and to evaluate factors associated to early and late mortality with this technique.Methods: This is a retrospective, observational and descriptive study of a single center.Results: During the study period were performed 35 heart transplants. Fifteen (42.9%) patients were in cardiogenic shock. The probability of survival was 74.8±7.8%, 60.4±11.3% and 15.1±13.4% at 1 year, 5 years and 10 years of follow-up, respectively. The median survival time was 96.6 months.Conclusion: The use of myocardial protection with retrograde cardioplegic solution may reduce the risks associated morbidity due to cold ischemia time during the heart transplant, and we suggest that this benefit may be even greater in cases of cold ischemia time longer ensuring protection to the myocardium.Descriptors: Heart transplantation. Transplantation. Heart arrest, induced. Myocardium. Follow-up studies.
ResumoIntrodução: Uma grande variedade de técnicas e soluções é utilizada na preservação do coração durante o transplante, o que demonstra a falta de método ideal na prática clínica. A
348Lavagnoli CFR, et al. -Associated factors with survivals in patients undergoing orthotopic heart transplant using retrograde blood microcardioplegia Bras Cir Cardiovasc 2012;27(3):347-54 INTRODUCTION A variety of techniques and solutions are used in the preservation of the heart during transplantation, demonstrating the lack of ideal method in clinical practice [1].
RevIn the present day, where the number of donors is not enough, in addition to the increase of high-risk recipients on the waiting list, every effort should be made towards better organ preservation. A better organ preservation leads to lower graft dysfunction and promotes better late outcomes after transplantation [2,3].The use of retrograde blood cardioplegia has been described in several studies in the literature. There is no consensus whether this strategy promotes adequate myocardial protection [4]. Its use for the administration of blood cardioplegia during implantation is frequently reported in the literature. This strategy of cardioplegia administration allows for continuous perfusion o...
“…Orthotopic CT can be used with bicaval anastomosis and prophylactic tricuspid annuloplasty 258,259 . In Brazil, CCC chagasic cardiomyopathy is the third most common indication for CT 260,261 .…”
Section: Cardiac and Cellular Transplantation And Other Surgical Thermentioning
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