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

This Article Full Text 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 Author home page(s): Gonzalo Pradas Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Peteiro, J. Articles by Beiras, A. C. Search for Related Content PubMed PubMed Citation Articles by Peteiro, J. Articles by Beiras, A. C.

J Thorac Cardiovasc Surg 1996;112:584-589
© 1996 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

DIFFERENCES IN HEART TRANSPLANT PHYSIOLOGY ACCORDING TO SURGICAL TECHNIQUE

Received for publication July 13, 1995 Revisions requested Sept. 11, 1995; revisions received Dec. 21, 1995 Accepted for publication Feb. 23, 1996. Address for reprints: Jesus Peteiro, MD, P/Ronda 5-4^oizda, 15011-A Coruña, Spain.

Abstract

A new cardiac transplantation technique that preserves the shape of the left atrium and leaves the right atrium intact has been introduced. To compare the new and the standard techniques, we studied cardiac physiology with Doppler echocardiography and catheterization in 26 patients who underwent operation with the standard technique (group A) and 11 who underwent operation with the new technique (group B). Right atrial dimensions were significantly lower in group B (right atrial area index 8.4 ± 1.5 vs 14.5 ± 1.9 cm²/m², p < 0.001), whereas left atrial dimensions were slightly lower (left atrial area index 10.8 ± 2.0 vs 16.4 ± 7.0 cm²/m², p = 0.07). Right atrial contraction, as reflected by peak late tricuspid velocity, was greater in group B (37 ± 15 vs 30 ± 10 cm/sec, p < 0.05). The subsequent systolic vena caval flow-velocity integral was also greater in group B at all respiratory phases (inspiration 10.0 ± 4.0 vs 5.2 ± 4.0 cm, p < 0.001; expiration 4.8 ± 1.9 vs 2.9 ± 1.4 cm, p < 0.001; apnea 5.3 ± 2.0 vs 2.9 ± 1.9 cm, p < 0.001) suggesting better atrial relaxation. Filling pressures on the right side of the heart were lower in group B (mean right atrial pressure 5.5 ± 2.4 vs 6.6 ± 2.8 mm Hg, p = 0.1; right atrial A wave 6.0 ± 3.1 vs 8.3 ± 3.2 mm Hg, p < 0.01; right atrial V wave 6.8 ± 3.1 vs 9.2 ± 3.2 mm Hg, p < 0.01; right ventricular end-diastolic pressure 5.6 ± 3.2 vs 7.3 ± 2.9 mm Hg, p < 0.05); however, no significant differences were found in left ventricular end-diastolic pressure or cardiac index. We conclude that patients undergoing the new technique exhibit cardiac physiologic improvements. Follow-up study is indicated to ascertain whether this finding implies improved long-term prognosis. (J THORACCARDIOVASC SURG1996;112:584-9)

This article has been cited by other articles:

				J. A. Tallaj, J. K. Kirklin, R. N. Brown, B. K. Rayburn, R. C. Bourge, R. L. Benza, L. Pinderski, S. Pamboukian, D. C. McGiffin, and D. C. Naftel Post-Heart Transplant Diastolic Dysfunction Is a Risk Factor for Mortality J. Am. Coll. Cardiol., September 11, 2007; 50(11): 1064 - 1069. [Abstract] [Full Text] [PDF]

				T. Aziz, M. Burgess, R. Khafagy, A. W. Hann, C. Campbell, A. Rahman, A. Deiraniya, and N. Yonan BICAVAL AND STANDARD TECHNIQUES IN ORTHOTOPIC HEART TRANSPLANTATION:MEDIUM-TERM EXPERIENCE IN CARDIAC PERFORMANCE AND SURVIVAL J. Thorac. Cardiovasc. Surg., July 1, 1999; 118(1): 115 - 122. [Abstract] [Full Text] [PDF]