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David E. Lammermeier
Takeshi Nakatani
Michael S. Sweeney
Michael P. Macris
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Ann Thorac Surg 1989;48:168-172
© 1989 The Society of Thoracic Surgeons

Articles

Effect of prior cardiac surgery on survival after heart transplantation

David E. Lammermeier, MD, Takeshi Nakatani, MD, Michael S. Sweeney, MD, Charles T. Van Buren, MD, Michael P. Macris, MD, J.Michael Duncan, MD, O.H. Frazier, MD*

Section of Transplantation, Division of Cardiovascular Surgery, Texas Heart Institute, and The Department of Surgery, University of Texas Medical School, Houston, Texas USA

* Address reprint requests to Dr Frazier, Texas Heart Institute, PO Box 20345, Houston, TX 77225.

We conducted a retrospective analysis of 182 adult orthotopic heart transplant patients who underwent operations at our institution between July 1982 and October 1987 to determine whether prior cardiac operation affects survival. Group I included the 72 patients (39.6%) who had undergone a previous cardiac operation or operations and group II, the 110 (60.4%) who had not. The mean age of the patients in group I was 52.1 ± 8.1 years and is group II, 46.1 ± 10.2 years (p < 0.01). The incidence of ischemic heart disease was 86.1% in group I and 29.1% in group II (p < 0.01). All patients received cyclosporine-based immunosuppression. More patients in group I than in group II required reoperation for bleeding after transplantation: 18 (25.0%) versus 9 (8.2%) (p < 0.01). The actuarial 1-year and 3-year survival rates were 77.6% and 66.5%, respectively, for group I and 77.1% and 66.3%, respectively, for group II. Because both groups had similar survival rates, we believe that prior cardiac operation in heart transplant recipients does not compromise long-term survival.




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