Management of peripheral vascular problems in recipients of cardiac allografts Academic Article Article uri icon

Overview

MeSH Major

  • Aorta, Thoracic
  • Aortic Diseases
  • Cardiac Surgical Procedures
  • Heart Defects, Congenital
  • Heart Valve Diseases
  • Practice Guidelines as Topic
  • Quality Assurance, Health Care
  • Vascular Surgical Procedures

abstract

  • Five hundred and twenty consecutive heart transplant cases (458 adult, 62 pediatric) were reviewed to assess the impact of peripheral vascular problems. Peritransplant interventions requiring vascular cannulation (e.g., intraaortic balloon pump procedures, catheterization of the right and left sides of the heart, femoral bypass) resulted in 10 complications that necessitated nine surgical procedures. Five aortic aneurysms (three infrarenal and two suprarenal) were resected. There was one death unrelated to the aneurysm resection. Sixteen patients had evidence of peripheral vascular disease (PVD). There were three deaths in this group, none directly related to the PVD. Three patients required vascular reconstruction (axillobifemoral, bilateral femoral distal and popliteal endarterectomy) in the posttransplant period, all for advanced ischemic symptoms. Except for one patient in whom ischemia-related ulcers developed on the heels, all patients had improved or stable symptoms that did not require intervention. There were no limb losses or vascular infections. We conclude that despite the rigors of posttransplant immunosuppression, patients with stable manifestations of PVD may successfully undergo heart transplantation and subsequent vascular reconstruction, when indicated, without prohibitive risk.

publication date

  • January 1992

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1016/0741-5214(92)90052-A

PubMed ID

  • 1460716

Additional Document Info

start page

  • 895

end page

  • 901; discussion 901-2

volume

  • 16

number

  • 6