SOME FEATURES OF ORTHOTOPIC HEART TRANSPLANTATION WITH DISCREPANCIES BETWEEN DONOR AND RECIPIENT AORTIC DIAMETERS
Abstract
At present heart transplantation is the most effective method for treating patients with terminal stage of heart insufficiency. And now the number of possible recipients exceeds the number of performing transplantations several times in the world [1]. Due to the limited number of donors there is a necessity to rational employment for donor organs [2]. Deficit of donor hearts urged on surgeons to extend selection criteria and demands for heart harvesting in so called suboptimal donors which leads to increased number and timeliness performance of transplantations [3, 4, 5]. In the present article we demonstrated two clinical cases with successful orthotopic heart transplantation (OHT) with donor organs usage, which differed rather significantly regarding aortic dimensions, and this fact necessitated performance of reduction aortoplasty in recipients. Besides, we presented a case with aт OHT patient with ascending aorta aneurism, complicated dissection type II DeBakey, who was indicated supracoronary grafting of the ascending aorta and a part of aortic arch before the transplantation.
About the Authors
K. O. Barbukhatti
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
V. S. Pykhteev
Kuban State Medical University, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
S. S. Babeshko
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
V. I. Kaleda
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
V. A. Porhanov
Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health
Russian Federation
Russian Federation
References
1. Попцов В.Н., Воронина О.В., Готье С.В. Кардиотоническая и вазоактивная терапия при трансплантации сердца. М., 2011. С. 27 - 35.
2. LaksH., Marelli D., Fonarow G.C. et al. Use of two recipient lists for adults requiring heart transplantation // J. Thorac. Cardiovasc. Surg. 2003. Vol. 125. P. 49 - 59.
3. Hertz MI. The Registry of the International Society for Heart and Lung Transplantation-Introduction to the 2012 annual reports: new leadership, same vision. J Heart Lung Transplant. 2012 Oct; 31 (10): 1045 - 1051.
4. Barth E., Durand M., Heylbroeck C. et al. Rossi-Blancher M. Extracorporeal life support as a bridge to high-urgency heart transplantation. Clin Transplant. 2012; 26 (3): 484 - 488.
5. Loisance D., Hillion M.L., Deleuze P. et al. Extracorporeal circulation with membrane oxygenation as a bridge to transplantation in cardiac surgical patients. Transplant Proc. 1987; 19 (5): 3786 - 3788.
6. Lopez C.E., Lopez M.J., de Diego J., Cortina J.M. Early acute aortic dissection of the donor aorta after orthotopic heart transplantation. Interact Cardiovasc Thorac Surg. 2009 Oct; 9(4): 715-6. doi: 10.1510/icvts.2009.210724. Epub 2009 Jul 13.
7. Wada S., Mitsui N., Mukai S., Sueda T., Matsuura Y., Roques X.F., Laborde M.N., Yssartier F., Baudet E.M. Rupture of donor ascending aorta following heart transplantation. Hiroshima J Med Sci. 1994 Jun; 43(2): 73 - 6.
8. Miralles A. Aortic mismatch in heart transplantation: readaptation. Ann Thorac Surg. 1997 Oct; 64(4): 1188 - 90.
9. Deleuze P.H., Mazzucotelli J.P., Benvenuti C., Aptecar E., Mourtada A., Benhaiem-Sigaux N., Habach B., Loisance D.Y., Cachera J.P. Donor/recipient aorta size mismatch in heart transplantation: a technical alternative. J Card Surg.1994 Jan; 9(1): 70 - 3.
10. Constanzo-Nordin M.R., Liao Y.L., Grusk B.B., et al. Oversizing of donor hearts: beneficial or detrimental? J Heart Lung Transplant 1991; 10: 717 - 30.
11. Tamisier D., Vouhe' P., Le Bidois J., Mauriat P., Khoury W., Leca F. Donor-recipient size matching in pediatric heart transplantation: a word of caution about small grafts. J Heart Lung Transplant 1996; 15: 190 - 5.
12. Fullerton D.A., Gundry S.R., Alonso de Begona J., et al. The effects of donor-recipient size disparity in infant and pediatric heart transplantation. J Thorac Cardiovasc Surg 1992; 104: 1314 - 9.
13. Yeoh T.K., Frist W.H., Lagerstrom C., et al. Relationship of cardiac allograft size and pulmonary vascular resistance to long-term cardiopulmonary function. J Thorac Cardiovasc Surg 1992; 6: 1168 - 76.
14. Kocher A., Ehrlich M., Khazen C., et al. Repair of an aorticaneurysm at the time of heart transplantation: report oftwo cases and review of the literature. Transplant Proc1999; 31: 3184 - 3186.
15. Kirali K., Eren E., Mataraci I., C’evirme D. Combined orthotopi cheart transplantation and prophylactic ascending aorta replacement in a Marfan patient. Turkish J Thorac Cardiovasc Surg 2011; 19: 434-6. Available at: tgkdc.dergisi.org/text.php3?idj1444. Accessed January 31, 2015.
16. Rajagopal K., Rogers J., Lodge A., et al. Two-stage totalcardioaortic replacement for end-stage heart and aorticdisease in Marfan syndrome: case report and reviewof the literature. J Heart Lung Transplant 2009; 28: 958-963.
17. Wei J., Sue S., Lee Y. and Chang C. Combined heart transplantationand total replacement of thoracic aorta inMarfan’s syndrome with recurrent aortic dissection: acase report. Transplant Proc 2012; 44: 1174 - 1175.
18. Rudez I., Planinc M., Unic' D., et al. Concomitant heart transplantation and replacement of ascending aorta and proximal aortic arch [Review]. J Cardiovasc Surg (Torino) 2013; 54: 661-662.
19. Rajagopal K., Rogers J., Lodge A. et al. Two-stage total cardio aortic replacement for end-stage heart and aortic disease in Marfan syndrome: case report and review of the literature. J Heart Lung Transplant 2009; 28: 958 - 963.
20. Kesler K., Hanosh J., O’Donnell J. et al. Heart transplantation in patients with Marfan’s syndrome: a survey of attitudes and results. J Heart Lung Transplant. 1994 Sep-Oct; 13(5): 899 - 904.
21. Macedo F., Salerno T., Pham S.Replacement of infected aortic prosthetic graft with aortic homograft after heart transplantation: 13-yearfollow-up. J Card Surg. 2013 May; 28(3): 312-4. doi: 10.1111/jocs.12097. Epub 2013 Mar 28.
22. Svensson L.G., Crawford E.S., Hess K.R., et al: Experiencewith 1509 patients undergoing thoraco-abdominal aorticoperations. J VascSurg 1993; 17: 357 -370.
23. Hargrove W.C., Edmunds L.H.: Management of infectedaortic prosthetics grafts. Ann Thorac Surg 1984; 37: 72 - 77.
24. Coselli J.S., Koksoy C., LeMaire S.A.: Management of thoracic aortic graft infections. Ann Thorac Surg 1999; 67: 1990 - 1993.
25. Knosalla C., Weng Y.G., Hammerschmidt R., Pasic M., Schmitt-Knosalla I., Grauhan O., et al. Orthotopic heart transplantation in patients with Marfan syndrome. Ann Thorac Surg 2007; 83: 1691 - 5.
26. Chu S.H., Chien C.Y., et al.Combined heart transplantation and resection of dissecting aneurysm of ascending aorta and aortic arch: a case report. Ann Thorac Cardiovasc Surg. 2000. Feb; 6 (1): 61.
Review
For citations:
Barbukhatti K.O., Pykhteev V.S., Babeshko S.S., Kaleda V.I., Porhanov V.A. SOME FEATURES OF ORTHOTOPIC HEART TRANSPLANTATION WITH DISCREPANCIES BETWEEN DONOR AND RECIPIENT AORTIC DIAMETERS. Innovative Medicine of Kuban. 2017;5(1):42-48. (In Russ.)
Views:
395
Email this article 
