Survival of Acute Intestinal Infarction after Cardiac Transplantation

Summary We report the case of a 52-year-old male who underwent total orthotopic heart transplantation for end-stage ischemic car diomyopathy. The postoperative course was complicated by acute intestinal infarction which was diagnosed after surgical exploration, and treated with a subtotal colectomy with Brooke ileostomy and closure of the distal sigmoid three days post transplant. The patient survived with nutritional support and broad antibiotic Prophylaxis. Review of the literature on acute abdominal complications after operations involving cardiopul monary bypass suggests that such complications are usually fatal. Detection and diagnosis may be obscured and treatment complicated by immunosuppression after cardiac transplanta tion. Because of the poor prognosis without appropriate man agement, a high level of suspicion, early and aggressive diag nostic measures, and swift surgical intervention are essential to survival.