title: Late cardiac reoperation after cardiac transplantation.
abstract: BACKGROUND
  The intermediate and long-term results of cardiac transplantation continue to improve. Subsequent cardiac procedures may be required to extend patient survival and protect graft function.
  
  
  METHODS
  The medical records of all adult and pediatric cardiac transplant recipients who underwent a subsequent cardiac procedure at our institution were reviewed.
  
  
  RESULTS
  Three hundred sixty patients have undergone primary orthotopic transplantation in our institution. Seventeen patients (12 adults, 5 children) underwent a subsequent procedure requiring cardiopulmonary bypass including cardiac retransplantation (10), coronary artery bypass grafting (3), ascending aortic replacement (2), tricuspid valve repair (1), and myotomy and myomectomy (1 patient). Mean interval from time of transplantation to second procedure was 8.3 years. There was one perioperative death. Two patients, both retransplants, died late postoperatively at 22 and 84 months, respectively. Overall mean follow-up in the late survivors is 26.6 months. All survivors are currently asymptomatic and doing well.
  
  
  CONCLUSIONS
  A variety of subsequent cardiac procedures, in addition to retransplantation, can be performed safely in carefully selected cardiac transplant recipients. The intermediate term results are gratifying in terms of survival and freedom from symptoms.
authors.affiliation: Department of Cardiac and Thoracic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: V Seenu
authors.initials: VS
authors.lastname: Reddy
authors.forename: Ho H
authors.initials: HH
authors.lastname: Phan
authors.forename: Richard N
authors.initials: RN
authors.lastname: Pierson
authors.forename: Davis C
authors.initials: DC
authors.lastname: Drinkwater
authors.forename: Paul A
authors.initials: PA
authors.lastname: Chang
authors.forename: Stacy F
authors.initials: SF
authors.lastname: Davis
authors.forename: Walter H
authors.initials: WH
authors.lastname: Merrill
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate