[Indications and results of orthotopic heart transplantation in coronary heart disease].
In parallel to increasing numbers of orthotopic heart transplantations performed during recent years, the proportion of patients with preexisting ischemic cardiomyopathy (ICM) enlarged. The present study examined peri- and postoperative risk factors and the prognosis of patients with coronary artery disease after orthotopic heart transplantation in comparison to a group with dilatated cardiomyopathy (DCM). This comparison revealed a higher risk of severe rejection episodes in patients with coronary artery disease, whereas infections were not more frequent. Graft atherosclerosis was found in a higher incidence in patients with preexisting ICM than in the DCM group. The overall incidence of graft atherosclerosis was less than 10% at one and at two years after orthotopic heart transplantation. Postoperative renal function was more impaired in the group of ICM patients, although blood levels of cyclosporine A were lower in this group. In the ICM group one and two year survival rates were 75% and 74%, respectively. Although survival rates are lower in this patient group, if compared to DCM patients (84% and 83%), orthotopic heart transplantation seems to be acceptable therapeutic alternative for endstage coronary artery disease.
Herrmann
G
G
Klinik für Thorax-, Herz- und Gefässchirurgie, Medizinischen Hochschule Hannover.
Haverich
A
A
Cremer
J
J
Fieguth
H G
HG
Jurmann
M
M
Wahlers
T
T
Borst
H G
HG
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000601:surgery; D002312:Cardiomyopathy, Hypertrophic / Q000601:surgery; D002423:Cause of Death; D003327:Coronary Disease / Q000601:surgery*; D003524:Cyclosporins / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000601:surgery; D016027:Heart Transplantation; D006439:Hemodynamics; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000601:surgery; D011183:Postoperative Complications / Q000401:mortality
D003524:Cyclosporins
Indikationen und Ergebnisse der orthotopen Herztransplantation bei koronarer Herzerkrankung.