Associated factors with survivals in patients undergoing orthotopic heart transplant using retrograde blood microcardioplegia

Ramos Lavagnoli, Carlos Fernando; de Oliveira Severino, Elaine Soraya Barbosa; de Souza Vilarinho, Karlos Alexandre; da Mota Silveira Filho, Lindemberg; de Oliveira, Pedro Paulo Martins; Petrucci, Orlando; Wilson Vieira, Reinaldo; Marcolino Braile, Domingo
July 2012
Brazilian Journal of Cardiovascular Surgery;jul-set2012, Vol. 27 Issue 3, p347
Academic Journal
Background: Several techniques and cardioplegic solutions have been used for heart preservation during transplant procedures. Unfortunately, there is a lack of ideal method for myocardial preservation in the clinical practice. The use of retrograde cardioplegia provides continuous infusion of cardioplegic solution during the graft implantation. This strategy may provide better initial recovery of the graft. The objective of this study is to describe the experience of a single center where all patients received the same solution for organ preservation and were subjected to continuous retrograde blood microcardioplegia during implantation of the graft and to evaluate factors associated to early and late mortality with this technique. Methods: This is a retrospective, observational and descriptive study of a single center. Results: During the study period were performed 35 heart transplants. Fifteen (42.9%) patients were in cardiogenic shock. The probability of survival was 74.8±7.8%, 60.4±11.3% and 15.1±13.4% at 1 year, 5 years and 10 years of follow-up, respectively. The median survival time was 96.6 months. Conclusion: The use of myocardial protection with retrograde cardioplegic solution may reduce the risks associated morbidity due to cold ischemia time during the heart transplant, and we suggest that this benefit may be even greater in cases of cold ischemia time longer ensuring protection to the myocardium.


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