https://scholars.lib.ntu.edu.tw/handle/123456789/638912
Title: | Impact of Previous Conventional Cardiac Surgery on the Clinical Outcomes After Heart Transplantation | Authors: | JENG-WEI CHEN HENG-WEN CHOU NAI-KUAN CHOU CHIH-HSIEN WANG NAI-HSIN CHI SHU-CHIEN HUANG HSI-YU YU YIH-SHARNG CHEN RON-BIN HSU |
Keywords: | heart transplantation; previous cardiac surgery; resternotomy; survival; ventricular assist device | Issue Date: | 2023 | Journal Volume: | 36 | Source: | Transplant international : official journal of the European Society for Organ Transplantation | Abstract: | The impact of the type, purpose, and timing of prior surgery on heart transplantation (HT) remains unclear. This study investigated the influence of conventional cardiac surgery (PCCS) on HT outcomes. This study analyzed HTs performed between 1999 and 2019 at a single institution. Patients were categorized into two groups: those with and without PCCS. Short-term outcomes, including post-transplant complications and mortality rates, were evaluated. Cox proportional and Kaplan-Meier survival analyses were used to identify risk factors for mortality and assess long-term survival, respectively. Of 368 patients, 29% had PCCS. Patients with PCCS had a higher incidence of post-transplant complications. The in-hospital and 1 year mortality rates were higher in the PCCS group. PCCS and cardiopulmonary bypass time were significant risk factors for 1 year mortality (hazard ratios = 2.485 and 1.005, respectively). The long-term survival rates were lower in the PCCS group, particularly in the first year. In sub-analysis, patients with ischemic cardiomyopathy and PCCS had the poorest outcomes. The era of surgery and timing of PCCS in relation to HT did not significantly impact outcomes. In conclusion, PCCS worsen the HT outcomes, especially in patients with ischemic etiology. However, the timing of PCCS and era of HT did not significantly affect this concern. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/638912 | ISSN: | 09340874 | DOI: | 10.3389/ti.2023.11824 |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
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