| Objective:To retrospectively analyze the survival status and echocardiographic characteristics of 108 patients undergoing orthotopic heart transplantation in Union Hospital of Fujian Medical Universityduring January 2006 to December 2016.Methods:A retrospective analysis of 108 patients undergoing orthotopic heart transplantation(OHT)during January 2006 to December 2016.Thereinto,Seventy-one patients undergoing OHT surgery were enrolled in the analysis of survival status;91 patients with OHT surgery were enrolled in analysis of mortality risk factors;69 patients with OHT surgery did not experience acute rejection,and were routinely followed up by transthoracic echocardiography(TTE)to analyze postoperative 1-year TTE data and explore the structure and function of the transplanted heart."Normal" changes were classified into group A(7 days postoperatively),group B(3 months postoperatively),group C(postoperative June),and group D(1 year postoperatively)depending on the time of postoperative examination.The parameters obtained from the selected conventional echocardiography were compared to analyze the changes of heart structure and function after cardiac transplantation.Moreover,analyze the causes of death and echocardiographic features of 13 patients,echocardiography report data of 15 patients with acute rejection(AR),and further analysis of which poor prognosis and better prognosis Cardiac structural and functional abnormal during AR.Result:1.From January 2009 to December 2015,the 1-,2-,and 3-year survival rates of 71 patients undergoing orthotopic heart transplantation were 92.4%,90.7%,and 86.2%,respectively.2.The cumulative incidence of AR in OHT patients was 8.9% after 1 year after surgery.The cumulative incidence of AR in the 5-year period was 30.7%,respectively,after which the cumulative incidence did not increase.3.The LVPW,IVS,and LVM were compared among the groups.The IVS values in group B and C were lower than those in group A.And there was no statistically significant difference between the other groups.LVPW were lower in group C and D than in group A.There was no statistically significant difference between the other groups.The LVM in group C and group D were lower than those in group A.There was no stati--stically significant difference between the other groups.4.The difference in pericardial effusion between groups was statistically significant.The proportion of patient with trace-mild pericardial effusion in group C(72.4%)and group D(84.8%)was higher than that in group A(45.5%),with statistical significance(P < 0.05).The degree of tricuspid regurgitation in each group was different,and the proportion of patient with trace-mild tricuspid regurgitation was lower in group C(96.8%)than in group A(75.8%),with statistical significance(P < 0.05).5.After 13 deaths in OHT patients,9 patients were examined by echocardiography before dying.Among them,only one patient had normal cardiac structure and 8 had significant changes in cardiac structure.However,the structural changes of these hearts were not concurruct and specific.6.Although the incidence of cardiac structural and functional abnormal in AR patients was higher than that of non-AR patients in conventional echocardiography,it was not concurruct.However,those changes effect the prognosis of AR patients,patients with moderate-to-severe EF decrease or simultaneous wall thickening and enlarged heart chambers may have poor prognosis.Conclusion:The survival rate after orthotopic heart transplantation from January 2009 to December 2015 in Fuzhou Union Hospital was higher than that of ISHLT.The younger patients in this group and the higher proportion of patients with cardiomyopathy had a positive effect.In the “normal” condition 1 year after orthotopic heart transplantation,left ventricular wall thickness and LVM were reduced in 3-6 month postoperatively,which may be due to the regression of myocardial edema after transplantation.The incidence of cardiac structural and functional changes in patients with AR and post-mortem heart transplantation was higher than that of “normal” patients,but it was not characteristic.However,in patients with AR,patients with moderate-to-severe EF decrease or simultaneous wall thickening and enlarged heart chambers may have poor prognosis. |
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