Tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazón

Background: Heart transplantation currently provides the most effective treatment for advanced heart failure. However, medical therapy for this condition has also improved, heart donors are scarce and the cost of the procedure is high. Therefore the indications and management of these patients need...

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Autores principales: Morán V,Sergio, Castro G,Pablo, Zalaquett S,Ricardo, Becker R,Pedro, Garayar P,Bernardita, Irarrázaval Ll,Manuel José, Jalil M,orge, Lema F,Guillermo, Fajuri N,Alejandro, Pérez P,Osvaldo, Martínez S,Alejandro, Marchant D,Eugenio, Chamorro S,Gastón
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2001
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000100002
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spelling oai:scielo:S0034-988720010001000022005-11-23Tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazónMorán V,SergioCastro G,PabloZalaquett S,RicardoBecker R,PedroGarayar P,BernarditaIrarrázaval Ll,Manuel JoséJalil M,orgeLema F,GuillermoFajuri N,AlejandroPérez P,OsvaldoMartínez S,AlejandroMarchant D,EugenioChamorro S,Gastón Heart failure congestive Heart transplantation Surgical procedures, operative Background: Heart transplantation currently provides the most effective treatment for advanced heart failure. However, medical therapy for this condition has also improved, heart donors are scarce and the cost of the procedure is high. Therefore the indications and management of these patients need reevaluation. Aim: To analyze the results of 24 patients submitted to heart transplantation for end-stage heart failure needing repeated hospitalizations and i.v. inotropes for compensation. Patients and methods: The group was comprised by 21 men and 3 women with a mean age of 36.8 years, mean left ventricular ejection fraction 19±4.5%, mean systolic pulmonary artery pressure 48±13 mmHg (24-70) and mean pulmonary vascular resistance 2.6 Wood Units (1-5). Fourteen patients (58%) had a previous median sternotomy. Immunosupression did not include induction therapy and steroids were discontinued early. Results: Operative mortality was 4% at 30 days. Actuarial survival at one year was 90% and at 5 years 72%. Freedom from rejection at one year was 76% and at 5 years 50%. Freedom from infection was 70% at one year and 56.5% at five years. All patients with more than 3 months of follow-up were in functional class I. Conclusions: These results justify the proposed modifications for transplantation protocols (Rev Méd Chile 2001; 129: 9-17).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.129 n.1 20012001-01-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000100002es10.4067/S0034-98872001000100002
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
topic Heart failure
congestive
Heart transplantation
Surgical procedures, operative
spellingShingle Heart failure
congestive
Heart transplantation
Surgical procedures, operative
Morán V,Sergio
Castro G,Pablo
Zalaquett S,Ricardo
Becker R,Pedro
Garayar P,Bernardita
Irarrázaval Ll,Manuel José
Jalil M,orge
Lema F,Guillermo
Fajuri N,Alejandro
Pérez P,Osvaldo
Martínez S,Alejandro
Marchant D,Eugenio
Chamorro S,Gastón
Tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazón
description Background: Heart transplantation currently provides the most effective treatment for advanced heart failure. However, medical therapy for this condition has also improved, heart donors are scarce and the cost of the procedure is high. Therefore the indications and management of these patients need reevaluation. Aim: To analyze the results of 24 patients submitted to heart transplantation for end-stage heart failure needing repeated hospitalizations and i.v. inotropes for compensation. Patients and methods: The group was comprised by 21 men and 3 women with a mean age of 36.8 years, mean left ventricular ejection fraction 19±4.5%, mean systolic pulmonary artery pressure 48±13 mmHg (24-70) and mean pulmonary vascular resistance 2.6 Wood Units (1-5). Fourteen patients (58%) had a previous median sternotomy. Immunosupression did not include induction therapy and steroids were discontinued early. Results: Operative mortality was 4% at 30 days. Actuarial survival at one year was 90% and at 5 years 72%. Freedom from rejection at one year was 76% and at 5 years 50%. Freedom from infection was 70% at one year and 56.5% at five years. All patients with more than 3 months of follow-up were in functional class I. Conclusions: These results justify the proposed modifications for transplantation protocols (Rev Méd Chile 2001; 129: 9-17).
author Morán V,Sergio
Castro G,Pablo
Zalaquett S,Ricardo
Becker R,Pedro
Garayar P,Bernardita
Irarrázaval Ll,Manuel José
Jalil M,orge
Lema F,Guillermo
Fajuri N,Alejandro
Pérez P,Osvaldo
Martínez S,Alejandro
Marchant D,Eugenio
Chamorro S,Gastón
author_facet Morán V,Sergio
Castro G,Pablo
Zalaquett S,Ricardo
Becker R,Pedro
Garayar P,Bernardita
Irarrázaval Ll,Manuel José
Jalil M,orge
Lema F,Guillermo
Fajuri N,Alejandro
Pérez P,Osvaldo
Martínez S,Alejandro
Marchant D,Eugenio
Chamorro S,Gastón
author_sort Morán V,Sergio
title Tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazón
title_short Tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazón
title_full Tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazón
title_fullStr Tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazón
title_full_unstemmed Tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazón
title_sort tratamiento de la insuficiencia cardíaca avanzada mediante trasplante de corazón
publisher Sociedad Médica de Santiago
publishDate 2001
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872001000100002
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