[Orthotopic heart transplant. Study of early morbimortality (< or = 30 days). Experience at the Reina Sofía Hospital (Córdoba)].
From may 1986 to december 1991, we have performed 90 heart transplantation in the Hospital "Reina Sofía" from Córdoba. In the present study we analyze the early morbidity and mortality in a retrospective study on complications and factors determining its incidence. Seventy patients were male (86%) and 13 female (14%). Age ranged from 12 and 65 years. The 31% of patients needed in pharmacological support before transplantation, 15 of them were operated in a emergency situation because of cardiogenic shock. The pulmonary resistances oscillated between 0.5 and 8.7 units/m2 (Wood) (mean 2.5 +/- 1.4 units/m2). The mean time of ischaemia was 136 +/- 38 minutes (range 5-255 min). Hospital mortality (< or = 30 days) was 8.8% (8/90). No predictive factors from donor and recipient were found. Three main influences on complications were analyzed: a) influence of myocardial temperature, b) role of hematic cardioplegia, and c) usefulness of Aprotinin. Eighteen patients (20%) developed severe bradyarrhythmia needing a pacemaker in the post-operative period. We found a significant relationship with myocardial temperature (4.3 +/- 2.1 vs 6.2 +/- 2.6; p < 0.05) and transport solution temperature (5.8 +/- 2.3 vs 7.3 +/- 1.9; p < 0.05). No significant influence was found on the time of ischaemia, previous heart disease, previous treatment with Amiodarona, clinical condition, etc.(ABSTRACT TRUNCATED AT 250 WORDS)
Concha
M
M
Servicio de Cirugía Cardiovascular, Hospital Universitario Reina Sofía, Córdoba.
Montero
A
A
Arizón
J M
JM
Anguita
M
M
Vallés
F
F
Calleja
F
F
Román
M
M
Casares
J
J
Jiménez
M A
MA
Alvarez
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D016027:Heart Transplantation; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013030:Spain; D013997:Time Factors