Concurrent Session: Cardiovascular I
Cardiovascular IConcurrent Session
Thursday, January 24, 2013
ADVANCES IN HEART TRANSPLANTATION ACROSS THE MILLENNIUM
Tittle M Rafiei M Osborne A Hamilton M Kobashigawa J. Cedars-Sinai Heart Institute, Los Angeles, CA
Purpose of Study: Since the first heart transplant in 1967, significant advances have been made in perioperative care and immunosuppression which have led to improved outcomes, establishing cardiac transplantation as the preferred treatment for appropriate patients with end-stage heart disease. In recent years, this has allowed sicker patients (on ventricular assist devices) to be considered for this therapy. It is not established whether this has adversely impacted post-transplant outcomes. We reviewed morbidity and mortality following cardiac transplantation in 3 contemporaneous eras straddling the millennium.
Methods Used: We evaluated 1058 patients between 1995 and 2009 and divided them by era of transplantation (Era 1 1995-1999 = 422 pts, Era 2 2000-2004 = 333 pts and Era 3 2005-2009 = 303 pts). We assessed 5-year actuarial survival, 5-year freedom from cardiac allograft vasculopathy (CAV), 5-year freedom from Non-Fatal Major Adverse Cardiac Events (NF-MACE, defined as myocardial infarction, heart failure, need for percutaneous cardiac intervention, stroke) and 1-year freedom from any treated rejection.
Summary of Results: 5-year survival, 5-year freedom from CAV and 1-yr freedom from any-treated rejection were all significantly greater in the most recent era (Era 3) compared to earlier periods. NF-MACE remained relatively unchanged through the eras.
Conclusions: Outcomes after heart transplantation continue to improve despite an expansion of the procedure to involve sicker patients (on ventricular assist devices).
ABNORMAL SINOATRIAL NODE PACEMAKING ACTIVITY OF ATRIAL-SPECIFIC SODIUM-CALCIUM EXCHANGER KNOCKOUT MICE
Goldstein ZM1, Torrente A2, Lamp ST2, Zhang R2, Chyu K 2, Philipson KD1, Goldhaber JI1,2. 1David Geffen …