Evaluation of early postoperative results after bicaval versus standard cardiac transplantation and review of the literature

Carmelo A. Milano, Ashish S. Shah, Peter Van Trigt, James Jaggers, R. Duane Davis, Donald D. Glower, Michael B. Higginbotham, Stuart D. Russell, Kevin P. Landolfo

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective: Previous studies have been inconsistent in defining a clinical benefit to the bicaval cardiac transplantation technique relative to the standard technique, and many major centers have not adopted this newer approach. The purpose of this study was to determine whether clinically significant benefits support utilization of the bicaval technique. Methods: Sixty-eight consecutive adult patients undergoing a standard cardiac transplant were compared with 75 consecutive patients who underwent the bicaval technique during the period from 1991 to 1999. Etiology, recipient sex, recipient age, donor age, and pulmonary vascular resistance were similar between the two groups. Results: Cardiac index at 24 hours after operation was increased for the bicaval group relative to the standard group (3.15 ± 0.7 vs 2.7 ± 0.5 L/min/m2, P < .05). Inotropic requirements were significantly less, and there was significantly less tricuspid regurgitation in the bicaval group relative to the standard grouls. In addition, the bicaval group more frequently had a nonpaced normal sihus rhythm at 24 hours after operation (73.9% vs 50.7% [standard group], P = .025) and had fewer postoperative arrhythmias (29.3% vs 47.7% [standard group], P < .01). Finally, although mortality was similar for the two groups, length of postoperative hospitalization was longer for the standard group relative to the bicaval group (12.1 ± 11 vs 20.4 ± 12 days, P < .001). Review of the literature identified reduced tricuspid regurgitation and improved rhythm as consistent benefits of the bicaval technique. Conclusion: This review demonstrates a clinical benefit during the early postoperative period with bicaval cardiac transplantation (relative to standard) and encourages further utilization of this technique.

Original languageEnglish (US)
Pages (from-to)717-721
Number of pages5
JournalAmerican Heart Journal
Volume140
Issue number5
DOIs
StatePublished - 2000
Externally publishedYes

Fingerprint

Heart Transplantation
Tricuspid Valve Insufficiency
Postoperative Period
Vascular Resistance
Cardiac Arrhythmias
Hospitalization
Tissue Donors
Transplants
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Milano, C. A., Shah, A. S., Van Trigt, P., Jaggers, J., Davis, R. D., Glower, D. D., ... Landolfo, K. P. (2000). Evaluation of early postoperative results after bicaval versus standard cardiac transplantation and review of the literature. American Heart Journal, 140(5), 717-721. https://doi.org/10.1067/mhj.2000.111105

Evaluation of early postoperative results after bicaval versus standard cardiac transplantation and review of the literature. / Milano, Carmelo A.; Shah, Ashish S.; Van Trigt, Peter; Jaggers, James; Davis, R. Duane; Glower, Donald D.; Higginbotham, Michael B.; Russell, Stuart D.; Landolfo, Kevin P.

In: American Heart Journal, Vol. 140, No. 5, 2000, p. 717-721.

Research output: Contribution to journalArticle

Milano, CA, Shah, AS, Van Trigt, P, Jaggers, J, Davis, RD, Glower, DD, Higginbotham, MB, Russell, SD & Landolfo, KP 2000, 'Evaluation of early postoperative results after bicaval versus standard cardiac transplantation and review of the literature', American Heart Journal, vol. 140, no. 5, pp. 717-721. https://doi.org/10.1067/mhj.2000.111105
Milano, Carmelo A. ; Shah, Ashish S. ; Van Trigt, Peter ; Jaggers, James ; Davis, R. Duane ; Glower, Donald D. ; Higginbotham, Michael B. ; Russell, Stuart D. ; Landolfo, Kevin P. / Evaluation of early postoperative results after bicaval versus standard cardiac transplantation and review of the literature. In: American Heart Journal. 2000 ; Vol. 140, No. 5. pp. 717-721.
@article{8309f1d324e747cf80287490f42ce173,
title = "Evaluation of early postoperative results after bicaval versus standard cardiac transplantation and review of the literature",
abstract = "Objective: Previous studies have been inconsistent in defining a clinical benefit to the bicaval cardiac transplantation technique relative to the standard technique, and many major centers have not adopted this newer approach. The purpose of this study was to determine whether clinically significant benefits support utilization of the bicaval technique. Methods: Sixty-eight consecutive adult patients undergoing a standard cardiac transplant were compared with 75 consecutive patients who underwent the bicaval technique during the period from 1991 to 1999. Etiology, recipient sex, recipient age, donor age, and pulmonary vascular resistance were similar between the two groups. Results: Cardiac index at 24 hours after operation was increased for the bicaval group relative to the standard group (3.15 ± 0.7 vs 2.7 ± 0.5 L/min/m2, P < .05). Inotropic requirements were significantly less, and there was significantly less tricuspid regurgitation in the bicaval group relative to the standard grouls. In addition, the bicaval group more frequently had a nonpaced normal sihus rhythm at 24 hours after operation (73.9{\%} vs 50.7{\%} [standard group], P = .025) and had fewer postoperative arrhythmias (29.3{\%} vs 47.7{\%} [standard group], P < .01). Finally, although mortality was similar for the two groups, length of postoperative hospitalization was longer for the standard group relative to the bicaval group (12.1 ± 11 vs 20.4 ± 12 days, P < .001). Review of the literature identified reduced tricuspid regurgitation and improved rhythm as consistent benefits of the bicaval technique. Conclusion: This review demonstrates a clinical benefit during the early postoperative period with bicaval cardiac transplantation (relative to standard) and encourages further utilization of this technique.",
author = "Milano, {Carmelo A.} and Shah, {Ashish S.} and {Van Trigt}, Peter and James Jaggers and Davis, {R. Duane} and Glower, {Donald D.} and Higginbotham, {Michael B.} and Russell, {Stuart D.} and Landolfo, {Kevin P.}",
year = "2000",
doi = "10.1067/mhj.2000.111105",
language = "English (US)",
volume = "140",
pages = "717--721",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Evaluation of early postoperative results after bicaval versus standard cardiac transplantation and review of the literature

AU - Milano, Carmelo A.

AU - Shah, Ashish S.

AU - Van Trigt, Peter

AU - Jaggers, James

AU - Davis, R. Duane

AU - Glower, Donald D.

AU - Higginbotham, Michael B.

AU - Russell, Stuart D.

AU - Landolfo, Kevin P.

PY - 2000

Y1 - 2000

N2 - Objective: Previous studies have been inconsistent in defining a clinical benefit to the bicaval cardiac transplantation technique relative to the standard technique, and many major centers have not adopted this newer approach. The purpose of this study was to determine whether clinically significant benefits support utilization of the bicaval technique. Methods: Sixty-eight consecutive adult patients undergoing a standard cardiac transplant were compared with 75 consecutive patients who underwent the bicaval technique during the period from 1991 to 1999. Etiology, recipient sex, recipient age, donor age, and pulmonary vascular resistance were similar between the two groups. Results: Cardiac index at 24 hours after operation was increased for the bicaval group relative to the standard group (3.15 ± 0.7 vs 2.7 ± 0.5 L/min/m2, P < .05). Inotropic requirements were significantly less, and there was significantly less tricuspid regurgitation in the bicaval group relative to the standard grouls. In addition, the bicaval group more frequently had a nonpaced normal sihus rhythm at 24 hours after operation (73.9% vs 50.7% [standard group], P = .025) and had fewer postoperative arrhythmias (29.3% vs 47.7% [standard group], P < .01). Finally, although mortality was similar for the two groups, length of postoperative hospitalization was longer for the standard group relative to the bicaval group (12.1 ± 11 vs 20.4 ± 12 days, P < .001). Review of the literature identified reduced tricuspid regurgitation and improved rhythm as consistent benefits of the bicaval technique. Conclusion: This review demonstrates a clinical benefit during the early postoperative period with bicaval cardiac transplantation (relative to standard) and encourages further utilization of this technique.

AB - Objective: Previous studies have been inconsistent in defining a clinical benefit to the bicaval cardiac transplantation technique relative to the standard technique, and many major centers have not adopted this newer approach. The purpose of this study was to determine whether clinically significant benefits support utilization of the bicaval technique. Methods: Sixty-eight consecutive adult patients undergoing a standard cardiac transplant were compared with 75 consecutive patients who underwent the bicaval technique during the period from 1991 to 1999. Etiology, recipient sex, recipient age, donor age, and pulmonary vascular resistance were similar between the two groups. Results: Cardiac index at 24 hours after operation was increased for the bicaval group relative to the standard group (3.15 ± 0.7 vs 2.7 ± 0.5 L/min/m2, P < .05). Inotropic requirements were significantly less, and there was significantly less tricuspid regurgitation in the bicaval group relative to the standard grouls. In addition, the bicaval group more frequently had a nonpaced normal sihus rhythm at 24 hours after operation (73.9% vs 50.7% [standard group], P = .025) and had fewer postoperative arrhythmias (29.3% vs 47.7% [standard group], P < .01). Finally, although mortality was similar for the two groups, length of postoperative hospitalization was longer for the standard group relative to the bicaval group (12.1 ± 11 vs 20.4 ± 12 days, P < .001). Review of the literature identified reduced tricuspid regurgitation and improved rhythm as consistent benefits of the bicaval technique. Conclusion: This review demonstrates a clinical benefit during the early postoperative period with bicaval cardiac transplantation (relative to standard) and encourages further utilization of this technique.

UR - http://www.scopus.com/inward/record.url?scp=0033766751&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033766751&partnerID=8YFLogxK

U2 - 10.1067/mhj.2000.111105

DO - 10.1067/mhj.2000.111105

M3 - Article

VL - 140

SP - 717

EP - 721

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 5

ER -