Villar H V, Neal D D, Levinson M, Fuller J M, Emery R W, Graham A R, Copeland J, Rhenman M J, Copeland J G
Department of Surgery, University of Arizona Health Sciences Center, Tucson 85724.
Am J Surg. 1989 Jan;157(1):168-74. doi: 10.1016/0002-9610(89)90441-8.
One hundred fifty-three patients underwent 159 heart transplants; 7 of these patients received 8 artificial hearts used as a bridge before implantation. The 1-year survival rate was 81 percent. One hundred forty gastrointestinal complications developed in 70 patients. Thirty-eight operations were required. Twenty-nine were intraabdominal operations. Of these, 22 were elective and 7 were emergency procedures. Five of the seven patients who underwent emergency procedures died, for an overall total mortality rate of 17 percent for major intraabdominal interventions. There were no complications or deaths in patients who underwent elective procedures. Major elective intraabdominal surgical interventions can be safely carried out in heart transplant patients. Repeated physical examination, aggressive use of endoscopy and imaging techniques, sound surgical judgement and a mutual relationship of trust and respect between cardiac and general surgeons are keys to a successful outcome.
153例患者接受了159例心脏移植手术；其中7例患者在植入前使用了8个人工心脏作为过渡。1年生存率为81%。70例患者出现了140例胃肠道并发症。共进行了38次手术。其中29次为腹部手术。在这些腹部手术中，22次为择期手术，7次为急诊手术。接受急诊手术的7例患者中有5例死亡，腹部主要手术的总死亡率为17%。接受择期手术的患者未出现并发症或死亡。心脏移植患者可以安全地进行大型择期腹部外科手术。反复体格检查、积极使用内镜和影像学技术、合理的手术判断以及心脏外科医生和普通外科医生之间相互信任和尊重的关系是取得成功结果的关键。
