A better long-term outcome in cardiac transplant recipient with a history of previous open heart operations

To investigate the effect of previous open heart operations (POHO) on the outcome of heart transplantation (HTX). Between November 1984 and May 1996, HTX was performed on 151 patients at Hartford Hospital. Among them, 61 patients had previous open heart operations (POHO) (group A), and 90 did not (g...

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Veröffentlicht in:Chinese medical journal 1998-03, Vol.111 (3), p.231-234
Hauptverfasser: Chen, C, Low, H B, Preissler, P L, Gallagher, R C, Hammond, J A, Takata, H, Schweizer, R T
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container_end_page 234
container_issue 3
container_start_page 231
container_title Chinese medical journal
container_volume 111
creator Chen, C
Low, H B
Preissler, P L
Gallagher, R C
Hammond, J A
Takata, H
Schweizer, R T
description To investigate the effect of previous open heart operations (POHO) on the outcome of heart transplantation (HTX). Between November 1984 and May 1996, HTX was performed on 151 patients at Hartford Hospital. Among them, 61 patients had previous open heart operations (POHO) (group A), and 90 did not (group B). The average follow-up period was 1615 +/- 1185 days for group A and 1330 +/- 1125 days for group B. The recipient age was 55 +/- 10 years for group A and 48 +/- 12 years for group B (P < 0.01). There were 17 patients (26%) in group A and 14 (50%) in group B who were over 60 years of age. There was more coronary artery disease (74% versus 37%, P < 0.001) as etiology, and more diabetics in group A (P < 0.02). The time for cardiopulmonary bypass (133 +/- 20 min versus 106 +/- 18 min, P < 0.01) and aortic clamp time (73 +/- 16 min versus 61 +/- 13 min, P < 0.01) were longer in group A. The operative mortality (within 30 days) was 0 and 2.2%, and the cumulative deaths were 16 (26%) and 43 (48%) respectively for group A and group B (P < 0.01). The causes of death were (group A vs group B): infection (31% vs 26%), rejection (13% vs 28%, P < 0.05), malignancy (25% vs 16%), cardiac event (6% vs 14%) and others (25% vs 16%). In patients over 60, there were 4 deaths (24%) in group A and 7 (50%) in group B. The difference was not significant. No patients died of rejection in this subgroup. The actuarial survival rates in group A versus group B were: 1 year, 93% versus 83%; 2 years, 85% versus 74%; 3 years, 81% versus 71%; 5 years, 76% versus 58%; and 10 years, 57% versus 24% (P < 0.01). The survival rate in patients who had POHO is much higher than that in patients who had HTX as their primary operation.
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Between November 1984 and May 1996, HTX was performed on 151 patients at Hartford Hospital. Among them, 61 patients had previous open heart operations (POHO) (group A), and 90 did not (group B). The average follow-up period was 1615 +/- 1185 days for group A and 1330 +/- 1125 days for group B. The recipient age was 55 +/- 10 years for group A and 48 +/- 12 years for group B (P < 0.01). There were 17 patients (26%) in group A and 14 (50%) in group B who were over 60 years of age. There was more coronary artery disease (74% versus 37%, P < 0.001) as etiology, and more diabetics in group A (P < 0.02). The time for cardiopulmonary bypass (133 +/- 20 min versus 106 +/- 18 min, P < 0.01) and aortic clamp time (73 +/- 16 min versus 61 +/- 13 min, P < 0.01) were longer in group A. The operative mortality (within 30 days) was 0 and 2.2%, and the cumulative deaths were 16 (26%) and 43 (48%) respectively for group A and group B (P < 0.01). The causes of death were (group A vs group B): infection (31% vs 26%), rejection (13% vs 28%, P < 0.05), malignancy (25% vs 16%), cardiac event (6% vs 14%) and others (25% vs 16%). In patients over 60, there were 4 deaths (24%) in group A and 7 (50%) in group B. The difference was not significant. No patients died of rejection in this subgroup. The actuarial survival rates in group A versus group B were: 1 year, 93% versus 83%; 2 years, 85% versus 74%; 3 years, 81% versus 71%; 5 years, 76% versus 58%; and 10 years, 57% versus 24% (P < 0.01). The survival rate in patients who had POHO is much higher than that in patients who had HTX as their primary operation.]]></description><identifier>ISSN: 0366-6999</identifier><identifier>PMID: 10374423</identifier><language>eng</language><publisher>China: Department of Cardiothoracic Surgery, Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China%Department of Surgery, Hartford Hospital, CT 06106, USA</publisher><subject>Adolescent ; Adult ; Aged ; Child ; Coronary Artery Bypass ; Coronary Disease - surgery ; Female ; Follow-Up Studies ; Heart Transplantation - mortality ; Humans ; Male ; Middle Aged ; Reoperation ; Retrospective Studies ; Survival Rate ; Treatment Outcome</subject><ispartof>Chinese medical journal, 1998-03, Vol.111 (3), p.231-234</ispartof><rights>Copyright © Wanfang Data Co. Ltd. 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Between November 1984 and May 1996, HTX was performed on 151 patients at Hartford Hospital. Among them, 61 patients had previous open heart operations (POHO) (group A), and 90 did not (group B). The average follow-up period was 1615 +/- 1185 days for group A and 1330 +/- 1125 days for group B. The recipient age was 55 +/- 10 years for group A and 48 +/- 12 years for group B (P < 0.01). There were 17 patients (26%) in group A and 14 (50%) in group B who were over 60 years of age. There was more coronary artery disease (74% versus 37%, P < 0.001) as etiology, and more diabetics in group A (P < 0.02). The time for cardiopulmonary bypass (133 +/- 20 min versus 106 +/- 18 min, P < 0.01) and aortic clamp time (73 +/- 16 min versus 61 +/- 13 min, P < 0.01) were longer in group A. The operative mortality (within 30 days) was 0 and 2.2%, and the cumulative deaths were 16 (26%) and 43 (48%) respectively for group A and group B (P < 0.01). The causes of death were (group A vs group B): infection (31% vs 26%), rejection (13% vs 28%, P < 0.05), malignancy (25% vs 16%), cardiac event (6% vs 14%) and others (25% vs 16%). In patients over 60, there were 4 deaths (24%) in group A and 7 (50%) in group B. The difference was not significant. No patients died of rejection in this subgroup. The actuarial survival rates in group A versus group B were: 1 year, 93% versus 83%; 2 years, 85% versus 74%; 3 years, 81% versus 71%; 5 years, 76% versus 58%; and 10 years, 57% versus 24% (P < 0.01). The survival rate in patients who had POHO is much higher than that in patients who had HTX as their primary operation.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Child</subject><subject>Coronary Artery Bypass</subject><subject>Coronary Disease - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Transplantation - mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0366-6999</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkMtOwzAQRbMA0VL4BeQVu0h2HDvxsqp4SZXYwDoaO07jktjGdqjK1xPUIlZzRjqa0b0X2RJTznMuhFhk1zHuMS4Yq_hVtiCYVmVZ0GX2sUZSp6QDGpzd5TOMyE1JuVEjY5GC0BpQKAWw0Q9gEwpaGW_0TAeTegSoNzG5cESuQz7oL-OmiJzXFvUaQvrFAMk4G2-yyw6GqG_Pc5W9Pz68bZ7z7evTy2a9zX1B65SXJamUwkXFWlVKwKyWTIACKTGBlnWs62olKbSEKC6BtzWpVSHnXWIhiaKr7P509wC2A7tr9m4Kdv7YfPdq3BMhakwxIf-iD-5z0jE1o4lKD3NOPadouChKzjGbxbuzOMlRt40PZoRwbP56pD82XXBg</recordid><startdate>19980301</startdate><enddate>19980301</enddate><creator>Chen, C</creator><creator>Low, H B</creator><creator>Preissler, P L</creator><creator>Gallagher, R C</creator><creator>Hammond, J A</creator><creator>Takata, H</creator><creator>Schweizer, R T</creator><general>Department of Cardiothoracic Surgery, Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China%Department of Surgery, Hartford Hospital, CT 06106, USA</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>2B.</scope><scope>4A8</scope><scope>92I</scope><scope>93N</scope><scope>PSX</scope><scope>TCJ</scope></search><sort><creationdate>19980301</creationdate><title>A better long-term outcome in cardiac transplant recipient with a history of previous open heart operations</title><author>Chen, C ; Low, H B ; Preissler, P L ; Gallagher, R C ; Hammond, J A ; Takata, H ; Schweizer, R T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p238t-4417cc0275dc4ba058b59acabb01ad5f5ff8cb3ad11c6ba6d818c2bad1b09b1c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Child</topic><topic>Coronary Artery Bypass</topic><topic>Coronary Disease - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Transplantation - mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, C</creatorcontrib><creatorcontrib>Low, H B</creatorcontrib><creatorcontrib>Preissler, P L</creatorcontrib><creatorcontrib>Gallagher, R C</creatorcontrib><creatorcontrib>Hammond, J A</creatorcontrib><creatorcontrib>Takata, H</creatorcontrib><creatorcontrib>Schweizer, R T</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>Wanfang Data Journals - Hong Kong</collection><collection>WANFANG Data Centre</collection><collection>Wanfang Data Journals</collection><collection>万方数据期刊 - 香港版</collection><collection>China Online Journals (COJ)</collection><collection>China Online Journals (COJ)</collection><jtitle>Chinese medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, C</au><au>Low, H B</au><au>Preissler, P L</au><au>Gallagher, R C</au><au>Hammond, J A</au><au>Takata, H</au><au>Schweizer, R T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A better long-term outcome in cardiac transplant recipient with a history of previous open heart operations</atitle><jtitle>Chinese medical journal</jtitle><addtitle>Chin Med J (Engl)</addtitle><date>1998-03-01</date><risdate>1998</risdate><volume>111</volume><issue>3</issue><spage>231</spage><epage>234</epage><pages>231-234</pages><issn>0366-6999</issn><abstract><![CDATA[To investigate the effect of previous open heart operations (POHO) on the outcome of heart transplantation (HTX). Between November 1984 and May 1996, HTX was performed on 151 patients at Hartford Hospital. Among them, 61 patients had previous open heart operations (POHO) (group A), and 90 did not (group B). The average follow-up period was 1615 +/- 1185 days for group A and 1330 +/- 1125 days for group B. The recipient age was 55 +/- 10 years for group A and 48 +/- 12 years for group B (P < 0.01). There were 17 patients (26%) in group A and 14 (50%) in group B who were over 60 years of age. There was more coronary artery disease (74% versus 37%, P < 0.001) as etiology, and more diabetics in group A (P < 0.02). The time for cardiopulmonary bypass (133 +/- 20 min versus 106 +/- 18 min, P < 0.01) and aortic clamp time (73 +/- 16 min versus 61 +/- 13 min, P < 0.01) were longer in group A. The operative mortality (within 30 days) was 0 and 2.2%, and the cumulative deaths were 16 (26%) and 43 (48%) respectively for group A and group B (P < 0.01). The causes of death were (group A vs group B): infection (31% vs 26%), rejection (13% vs 28%, P < 0.05), malignancy (25% vs 16%), cardiac event (6% vs 14%) and others (25% vs 16%). In patients over 60, there were 4 deaths (24%) in group A and 7 (50%) in group B. The difference was not significant. No patients died of rejection in this subgroup. The actuarial survival rates in group A versus group B were: 1 year, 93% versus 83%; 2 years, 85% versus 74%; 3 years, 81% versus 71%; 5 years, 76% versus 58%; and 10 years, 57% versus 24% (P < 0.01). The survival rate in patients who had POHO is much higher than that in patients who had HTX as their primary operation.]]></abstract><cop>China</cop><pub>Department of Cardiothoracic Surgery, Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China%Department of Surgery, Hartford Hospital, CT 06106, USA</pub><pmid>10374423</pmid><tpages>4</tpages></addata></record>
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source MEDLINE; Alma/SFX Local Collection
subjects Adolescent
Adult
Aged
Child
Coronary Artery Bypass
Coronary Disease - surgery
Female
Follow-Up Studies
Heart Transplantation - mortality
Humans
Male
Middle Aged
Reoperation
Retrospective Studies
Survival Rate
Treatment Outcome
title A better long-term outcome in cardiac transplant recipient with a history of previous open heart operations
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