Prior sternotomy increases the mortality and morbidity of adult heart transplantation

Transplantation Proceedings
M AwadF Esmailian

Abstract

This study investigated the effect of prior sternotomy (PS) on the postoperative mortality and morbidity after orthotopic heart transplantation (HTx). Of 704 adults who underwent HTx from December 1988 to June 2012 at a single institution, 345 had no PS (NPS group) and 359 had ≥ 1 PS (PS group). Survival, intraoperative use of blood products, intensive care unit (ICU) and hospital stays, frequency of reoperation for bleeding, dialysis, and >48-hour ventilation were examined. The NPS and PS groups had similar 60-day survival rates (97.1 ± 0.9% vs 95.3 ± 1.1%; P = .20). However, the 1-year survival was higher in the NPS group (94.7 ± 1.2% vs 89.7 ± 1.6%; hazard ratio [HR], 1.98; 95% CI, 1.12-3.49; P = .016). The PS group had longer pump time and more intraoperative blood use (P < .0001 for both). Postoperatively, the PS group had longer ICU and hospital stays, and higher frequencies of reoperation for bleeding and >48-hour ventilation (P < .05 for all comparisons). Patients with 1 PS (1PS group) had a higher 60-day survival rate than those with ≥ 2 PS (2+PS group; 96.7 ± 1.1% vs 91.1 ± 3.0%; HR, 2.70; 95% CI, 1.04-7.01; P = .033). The 2+PS group had longer pump time and higher frequency of postoperative dialysis (P < .05 for both...Continue Reading

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Citations

Apr 26, 2019·Heart Failure Reviews·Sanjeet Singh Avtaar SinghNawwar Al-Attar
Nov 7, 2017·Interactive Cardiovascular and Thoracic Surgery·Daisuke YoshiokaKoji Takeda
Mar 28, 2018·Interactive Cardiovascular and Thoracic Surgery·Sasha StillBrian Lima
Apr 24, 2018·The Annals of Thoracic Surgery·Matthew J O'ConnorKimberly Y Lin
Aug 19, 2021·Current Problems in Cardiology·Ahmed Al-AdhamiNawwar Al-Attar

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