title: Heart transplantation after cardioverter-defibrillator implantation. A case control study.
abstract: A case control study was performed to determine whether previous implantable cardioverter-defibrillator (ICD) insertion adversely affects outcome after heart transplantation. Six male heart transplant recipients who had undergone ICD insertion 12 +/- 5 months before heart transplantation were compared to a cohort of six heart transplant recipients who were matched according to age, preoperative status and hemodynamics, date of transplantation, graft ischemic time, history of a previous cardiac operation, and duration of follow-up. There were no significant differences in operating room time, chest tube drainage, time to extubation, and the duration of intensive care unit or hospital stay between the two groups. Furthermore, there were no significant differences in the number of units of packed cells, fresh frozen plasma, platelets and cryoprecipitate transfused. The number of treated rejection episodes and the number of patients requiring intravenous antibiotics for infection in the first 90 days was identical between groups. It was concluded that heart transplantation after ICD implantation did not appear to carry more risk than heart transplantation after a previous cardiac operation. Our limited experience supports the potential use of the ICD in patients with life-threatening ventricular dysrhythmias who are awaiting transplantation.
authors.affiliation: Division of Cardiovascular-Thoracic Surgery, University Hospital, London, Ontario, Canada.
authors.forename: R J
authors.initials: RJ
authors.lastname: Novick
authors.forename: A H
authors.initials: AH
authors.lastname: Menkis
authors.forename: G M
authors.initials: GM
authors.lastname: Guiraudon
authors.forename: D
authors.initials: D
authors.lastname: Sandler
authors.forename: P W
authors.initials: PW
authors.lastname: Pflugfelder
authors.forename: W J
authors.initials: WJ
authors.lastname: Kostuk
authors.forename: R
authors.initials: R
authors.lastname: Yee
authors.forename: G J
authors.initials: GJ
authors.lastname: Klein
authors.forename: A M
authors.initials: AM
authors.lastname: Powell
authors.forename: F N
authors.initials: FN
authors.lastname: McKenzie
mesh_terms: D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D016022:Case-Control Studies; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D006084:Graft Rejection; D016027:Heart Transplantation; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications