Purpose
Accurate assessment of atrial function has a significant impact in the follow-up of patients with orthotopic heart transplantation (1). Traditionally, most of cardiac transplantations have been performed according to the biatrial anastomotic technique (2). This surgical technique results in sinus node dysfunction (3), valvular insufficiency (4), and thrombus formation(5) . Development of bicaval technique (6-8) has shown to derive in smaller atrial volumes, more physiologic atrial contraction, more synchronous function of these chambers, and fewer atrioventricular valve regurgitation (9, 10). Moreover, the bicaval technique apparently...
Methods and Materials
Patient populationTwenty-nine consecutive heart transplant recipients referred for exclusion of cardiac allograft vasculopathy and assess allograft function were evaluated with contrast-enhanced retrospectively ECG-gated cardiac DSCT. Additional cardiac MR examination was performed within 1 month before the DSCT examination. Standard exclusion criteria for coronary MDCT angiography and MRI were applied. To be eligible for this study heart transplant recipients had to be in sinus rhythm and present normal renal function (creatinine <1.4 mg/dl). Individuals with known allergy to iodated contrast media, renal failure (creatinine >1.4 mg/dl),...
Results
Patient populationTwenty-nine consecutive heart transplant recipients (27 men, 2 women) with a mean age of 64.1±13years (age range 26–80) underwent cardiac DSCT and MRI. Patient characteristics are shown in Table 1. Overall mean time from transplantation to study enrolment was 122.8±69.7 months (range: 37–236 months). The mean heart rate was 85.9 ± 10.1 beats per minute (bpm) during DSCT (range: 68-107) and 86.1 ± 9.5 bpm (range: 64-114) during MRI (p=0.91, N.S). Among the twenty-nine orthotopic heart transplant recipients thirteen were operated with the standard biatrial technique and sixteen...
Conclusion
Our findings reveal that DSCT accurately estimates left atrial volumes and function in orthotopic heart transplant recipients. DSCT tends to overestimate left atrial volumes and undererestimate the ejection fraction when compared with MRI. The bicaval surgical technique offers improved left atrial volumes and function compared with the standard biatrial anastomotic technique as assessed by DSCT. Thus, DSCT may allow comprehensive evaluation of coronary allograft vasculopathy and left atrial and ventricular function during the diagnosis and follow-up process in orthotopic heart transplant recipients and provide useful...
References
1. Taylor DO, Edwards LB, Aurora P, et al. Registry of the International Society for Heart and Lung Transplantation: twenty-fifth official adult heart transplant report--2008. J Heart Lung Transplant 2008; 27:943-956.2. Lower RR, Stofer RC, Shumway NE. Homovital transplantation of the heart. J Thorac Cardiovasc Surg 1961; 41:196-204.3. DiBiase A, Tse TM, Schnittger I, Wexler L, Stinson EB, Valantine HA. Frequency and mechanism of bradycardia in cardiac transplant recipients and need for pacemakers. Am J Cardiol 1991; 67:1385-1389.4. Chan MC, Giannetti N, Kato T, et...
Personal Information
Gorka BastarrikaDepartment of RadiologyClínica Universidad de NavarraAvenida Pío XII, 3631008 PamplonaSPAINIf you have any queryoryou want to make any comment on this scientific exhibit please do not hesitate to contact me at:
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