[Late cerebrovascular complications of cardiac transplantation].
The occurrence of stroke after the post-operative period of cardiac transplantation is a rare event, and the role of the cardiac transplant in these patients, who often have various vascular risk factors, is unclear. We reviewed the clinical records of 303 consecutive patients with orthotopic cardiac transplantation performed from March 1985 to December 1996 and selected those who developed a stroke over the first 2 months postoperatively, in order to evaluate the frequency and the mechanisms of late cerebrovascular complications. Four patients had presented cerebral infarct and two intracranial hemorrhage. The overall risk of late cerebrovascular complications was 2.6p.100 at 5 years. Ischemic stroke was related to cardiac embolus in one patient, lacunar infarction in another, and was of undetermined etiology in two cases. In addition to vascular risk factors prior to transplantation and the development of intracardiac thrombus, immunosuppressive therapy, the surgical procedure and cardiac rejection may play a role in the occurrence of stroke in such patients.
Guillon
B
B
Clinique Neurologique, Hôpital G et R. Laennec, Saint-Herblain, Nantes, France. Benoit.Guillon@sante.univ-nantes.fr
Wiertlewski
S
S
Trochu
J N
JN
Desal
H
H
Treilhaud
M
M
Michaud
J L
JL
Bouhour
J B
JB
Fève
J R
JR
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D014057:Tomography, X-Ray Computed