The incidence, morbidity, and mortality of surgical procedures after orthotopic heart transplantation

Bhatia, Devinder S., Bowen, John C., Money, Samuel R., van Meter, Clifford H, McFadden, P. Michael, Kot, James B., Pridjian, Ara K., Ventura, Hector O., Mehra, Mandeep R., Smart, Frank W. and Ochsner, John L. (1997). The incidence, morbidity, and mortality of surgical procedures after orthotopic heart transplantation. In: 108th Annual Scientific Session of the Southern-Surgical-Association, Palm Beach, Fl, United States, (686-693). 1-4 December 1996. doi:10.1097/00000658-199706000-00006

Author Bhatia, Devinder S.
Bowen, John C.
Money, Samuel R.
van Meter, Clifford H
McFadden, P. Michael
Kot, James B.
Pridjian, Ara K.
Ventura, Hector O.
Mehra, Mandeep R.
Smart, Frank W.
Ochsner, John L.
Title of paper The incidence, morbidity, and mortality of surgical procedures after orthotopic heart transplantation
Conference name 108th Annual Scientific Session of the Southern-Surgical-Association
Conference location Palm Beach, Fl, United States
Conference dates 1-4 December 1996
Journal name Annals of Surgery   Check publisher's open access policy
Place of Publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Publication Year 1997
Sub-type Fully published paper
DOI 10.1097/00000658-199706000-00006
ISSN 0003-4932
Volume 225
Issue 6
Start page 686
End page 693
Total pages 7
Language eng
Formatted Abstract/Summary
Objective: The authors present their experience with patients having undergone orthotopic heart transplantation (OHT) in whom surgical conditions subsequently developed that required operative intervention. The incidence, morbidity and mortality of these procedures are reported.

Summary Background Data: Several studies have evaluated the management options of biliary tract disease after OHT. Multiple reports of patients having undergone OHT who subsequently underwent peripheral vascular reconstructions, plastic reconstructive, and thoracic procedures also have been published.

Methods: A chart review of 349 patients who underwent OHT between 1985 and 1996 was conducted to identify surgical procedures that were required in the post transplant period. Their outcomes are reported. Results: Of 349 patients who underwent OHT, conditions requiring 94 surgical procedures developed in 54 patients (15%). Biliary tract disease developed in 17 patients (5%) who required cholecystectomy; 2 of the 5 patients with acute cholecystitis died. Eight patients (2%) underwent orthopedic procedures with no operative mortality. Flap advancements for sternal wound infections were performed in five patients and four deaths occurred. Seventeen thoracic procedures were performed in 11 patients with an overall mortality of 45%. Twenty one vascular procedures were performed on 17 patients with 1 delayed death due to a malignancy. Seven patients underwent procedures of the colon and rectum with no mortality. Seven patients underwent repair of inguinal or incisional hernias with no mortality. Various infections occurred with one resultant death after operative intervention. Six procedures were performed for diseases of the small intestine with no resultant mortalities.

Conclusions: Patients having undergone OHT and chronic immunosuppression are at increased risk of having complications develop from infection. Acute cholecystitis and sternal wound infection caused an inordinate risk of complications and death. Malignancies developed in four patients who required surgical intervention. A heightened awareness of coexisting peripheral vascular disease in patients transplanted for ischemic cardiomyopathy should exist. Close screening before surgery and surveillance after surgery to identify risk factors for infection and vascular disease and to screen for malignancies are essential.
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:07:53 EST