HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Johnson, M. R. Articles by Sullivan, H. J. Search for Related Content PubMed PubMed Citation Articles by Johnson, M. R. Articles by Sullivan, H. J.

The Annals of Thoracic Surgery, Vol 55, 876-882, Copyright © 1993 by The Society of Thoracic Surgeons

ARTICLES

High-risk cardiac operation: a viable alternative to heart transplantation

MR Johnson, MR Costanzo-Nordin, AL Heroux, WG Kao, GM Mullen, R Pifarre and HJ Sullivan
Department of Medicine, Loyola University of Chicago, Maywood, Illinois 60153.

To determine if high-risk heart operation with circulatory support standby is an acceptable alternative to direct heart transplantation, we reviewed 21 patients who were accepted as heart transplant candidates but offered a heart operation because of the availability of circulatory support. Preoperative left ventricular ejection fraction was 0.25 +/- 0.08 (mean +/- standard deviation), and New York Heart Association functional class was 3.4 +/- 0.7. The patients underwent 16 bypass graft operations, 4 mitral and 2 aortic valve replacements, and 4 defibrillator implantations (combined procedures in 5 patients). An intraaortic balloon pump was placed in 12 patients. One patient required biventricular assist device support but was weaned in 11 days. Twenty patients were discharged 14.8 +/- 11.5 days postoperatively. One patient died 15 days postoperatively of amiodarone-induced respiratory failure, and 1 died suddenly 2 months postoperatively. At 10.5 +/- 6 months postoperatively, 19 patients (90%) are alive. Mean functional class is 1.9 +/- 0.9. None of the patients has undergone transplantation, but 2 are awaiting donor organs. We conclude that in selected heart transplant candidates high-risk heart operation is a viable alternative to direct heart transplantation.

This article has been cited by other articles:

				J. T. Cope, A. K. Kaza, C. C. Reade, K. S. Shockey, J. A. Kern, C. G. Tribble, and I. L. Kron A cost comparison of heart transplantation versus alternative operations for cardiomyopathy Ann. Thorac. Surg., October 1, 2001; 72(4): 1298 - 1305. [Abstract] [Full Text] [PDF]

				J. Collinson, M. Henein, M. Flather, J. R. Pepper, and D. G. Gibson Valve Replacement for Aortic Stenosis in Patients With Poor Left Ventricular Function : Comparison of Early Changes With Stented and Stentless Valves Circulation, November 9, 1999; 100(90002): II-1 - 5. [Abstract] [Full Text] [PDF]

				G. D. Trachiotis, W. S. Weintraub, T. S. Johnston, E. L. Jones, R. A. Guyton, and J. M. Craver Coronary artery bypass grafting in patients with advanced left ventricular dysfunction Ann. Thorac. Surg., November 1, 1998; 66(5): 1632 - 1639. [Abstract] [Full Text] [PDF]

				P. M. McCarthy, R. C. Starling, J. Wong, G. M. Scalia, T. Buda, R. L. Vargo, MSN, M. Goormastic, J. D. Thomas, N. G. Smedira, et al. EARLY RESULTS WITH PARTIAL LEFT VENTRICULECTOMY J. Thorac. Cardiovasc. Surg., November 1, 1997; 114(5): 755 - 765. [Abstract] [Full Text]

				A. S. Wechsler Editorial on "Coronary Artery Bypass Grafting in Patients With an Ejection Fraction of Twenty Percent or Less" J. Thorac. Cardiovasc. Surg., May 1, 1996; 111(5): 998 - 1000. [Full Text]

				M. R. Costanzo, S. Augustine, R. Bourge, M. Bristow, J. B. O'Connell, D. Driscoll, and E. Rose Selection and Treatment of Candidates for Heart Transplantation : A Statement for Health Professionals From the Committee on Heart Failure and Cardiac Transplantation of the Council on Clinical Cardiology, American Heart Association Circulation, December 15, 1995; 92(12): 3593 - 3612. [Abstract] [Full Text]

				S. E. Langenburg, S. A. Buchanan, L. H. Blackbourne, R. P. Scheri, K. N. Sinclair, J. Martinez, W. D. Spotnitz, C. G. Tribble, and I. L. Kron Predicting Survival After Coronary Revascularization for Ischemic Cardiomyopathy Ann. Thorac. Surg., November 1, 1995; 60(5): 1193 - 1196. [Abstract] [Full Text]