• Yu Matsumoto, Sho C Shibata, Akihiko Maeda, Daisuke Yoshioka, Takahiko Kamibayashi, Akinori Uchiyama, Yoshiki Sawa, and Yuji Fujino.
• Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
• J Anesth. 2015 Dec 1; 29 (6): 868-73.

PurposeThis study reviews our experience with the perioperative management of heart transplant (HT) recipients and explores how prior ventricular assist device (VAD) support affects the requirements for postoperative mechanical ventilation and circulatory support.Methods And ResultsA retrospective database review was performed from 2007 to 2014. Early postoperative outcomes were compared between VAD and non-VAD groups. Forty-four patients were studied. The mean age was 38 ± 13 years, 30% were female, and 88% experienced non-ischemic heart failure. Forty patients (91%) required VAD support at the time of HT, with a mean duration of 864 ± 351 days. The median postoperative mechanical ventilation times in the VAD and non-VAD groups were 54 [95% confidence interval (CI) 42.9-297.3] and 15 (95% CI 4.8-30.0; p = 0.0199) hours, respectively. The VAD group experienced increased bleeding during the first 48 h after HT (6.7 ± 3.5 vs. 1.8 ± 0.75 l, p = 0.004). Mechanical circulatory support with intra-aortic balloon pumping or venoarterial extracorporeal membrane oxygenation was required in 30% of VAD group patients. Increased bleeding and primary graft failure were the main causes of prolonged mechanical ventilation.ConclusionsHT recipients with VAD support required longer mechanical ventilation periods and mechanical circulatory support in the postoperative period.

27 keywords...

hide…