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Coronary artery bypass graft surgery during heart transplantation

We report the case of a patient who was submitted to coronary artery bypass graft surgery (CABG) during heart transplant as, during bench exploration, the donor heart presented a palpable atherosclerotic lesion in the anterior descending artery, not detected before harvesting. The patent internal thoracic artery from a previous CABG was used.

Aortic valve surgery in patients who had undergone surgical myocardial revascul...

OBJECTIVES: A very high percentage of patients submitted to coronary artery bypass grafting (CABG) develop symptomatic aortic disease requiring surgery upon ageing. The surgical risk of the redo procedure is controversial. We describe our recent experience with patients submitted to this surgery under such conditions. METHODS: From July 1999 to July 2010, 51 patients (mean age, 70.3 ± 7.0 years, 86.3% male) sub...

Intracardiac aorto-right atrial tunnel

Diabetes as an outcome predictor after heart transplantation

We aimed to compare post-transplantation morbidity and survival among heart transplant recipients with and without diabetes mellitus. A retrospective review of 141 adult patients submitted to heart transplantation from November 2003 to June 2009 (with a minimum follow-up of one year) was undertaken. The patients were divided into two groups: those with (29%) and those without (71%) pre-transplantation diabetes....

Complications of endomyocardial biopsy in heart transplant patients: a retrospe...

BACKGROUND: Endomyocardial biopsy (EMB) remains the gold standard for the diagnosis of graft rejection after heart transplantation (HT). Our purpose was to evaluate the rate of complications of this invasive procedure. METHODS: This was a retrospective study of 175 patients, who were transplanted between November 2003 and October 2010 and survived more than 1 month after surgery. We evaluated the number of inc...

Aortic root enlargement does not increase the surgical risk and short-term pati...

Objective: To analyze the short-term outcome of aortic root enlargement (ARE) using death and adverse events as end points. Methods: From January 1999 through December 2009, 3339 patients were subjected to aortic valve replacement (AVR). A total of 678 were considered to have small aortic roots (SARs) in which an aortic prosthesis size 21mm or smaller was implanted. ARE using a bovine pericardial patch was perf...

Diabetes mellitus does not affect one-year outcome after heart transplantation

BACKGROUND AND AIMS: Heart transplantation remains the gold standard treatment for selected patients with end-stage heart failure. However, transplantation in diabetic patients remains controversial. The hyperglycemic effect of immunosuppressant therapy further complicates posttransplantation management of diabetes and, although this is still unproven, could be responsible for a higher incidence of post-transpl...

Transplantação cardíaca: cinco anos de actividade

OBJECTIVE: To analyze the initial five years experience of the new heart transplant program of Coimbra University Hospitals. METHODS: Between November 2003 aid December 2008, 132 patients were transplanted, with a mean age of 52.0 years (range 3-71 years), of whom 98 were male (74%). Half of the patients had dilated cardiomyopathy and 33% ischemic cardiomyopathy. The mean age of donors was 31.7 years and 102 w...

Coronary fistulas after cardiac transplantation

Endocarditis of the mitral valve with left ventricular atrial fistula