Preexisting Heart Disease Does Not Affect Lung Transplant Outcome
PARIS (Reuters Health) Apr 27 - The presence of coronary artery disease (CAD) should not preclude lung transplantation, researchers announced here at the 29th Annual Meeting and Scientific Sessions of the International Society for Heart and Lung Transplantation (ISHLT).
“We believe that favorable outcomes can be achieved after lung transplantation in patients with mild, moderate, or severe CAD provided that patients have adequate coronary revascularization done either before or at the time of the transplant procedure,” Dr. Lisardo Garcia-Covarrubias, currently an attending cardiothoracic surgeon at the Baptist Health System in Miami, told Reuters Health.
Dr. Garcia-Covarrubias reported the results of a retrospective study of 119 CAD patients who underwent lung transplantation and 555 lung transplant patients without CAD. All of the patients underwent the procedure between January 1997 and August 2008 at the University of Pittsburgh Medical Center, where Dr. Garcia-Covarrubias was a clinical instructor and fellow.
Overall, 20 (16.8%) patients had mild disease; 23 (19.3%) had moderate disease; and 76 (63.8%) patients had severe disease.
The most common indications for lung transplantation were emphysema (40.3% of patients) and pulmonary fibrosis (47.05%). Most patients had a single-lung transplant.
The results showed that patients with single-, double-, and triple-vessel disease had the same early and late survival rates and that there was no difference in survival rates between patients with and patients without CAD.
“Specifically, we found that 1-year survival for these three groups individually and as a whole was 85% and the 5-year survival rate was 50%, and the rates were the same for patients with and without CAD,” Dr. Garcia-Covarrubias noted.
“Our results were very good…it is important to remember that patients presented for a lung transplant only after their CAD had been addressed either by percutaneous intervention involving a stent or open-heart surgery,” he added.
“Historically, CAD patients are not considered for lung transplant because of the perceived high risk for cardiac complications. Many lung patients have some degree of CAD, and careful patient selection can provide acceptable outcomes.”
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