Standard versus bicaval techniques for orthotopic heart transplantation: An analysis of the United Network for Organ Sharing database Ryan R. Davies,

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Presentation transcript:

Standard versus bicaval techniques for orthotopic heart transplantation: An analysis of the United Network for Organ Sharing database Ryan R. Davies, MD, Mark J. Russo, MD, MS, Jeffrey A. Morgan, MD, Robert A. Sorabella, BA, Yoshifumi Naka, MD, PhD, Jonathan M. Chen, MD The Journal of Thoracic and Cardiovascular Surgery Volume 140, Issue 3, Pages 700-708.e2 (September 2010) DOI: 10.1016/j.jtcvs.2010.04.029 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Transplantations performed by using each anastomosis type, as reported to the UNOS database by year from 1997 to 2007. White columns, Number of biatrial anastomoses; black columns, number of bicaval anastomoses; cross-hatched columns, number of total orthotopic anastomosis. Lines indicate the percentage of transplantations in that year performed with either biatrial (white diamonds) or bicaval (black diamonds) anastomosis. P < .0001. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 700-708.e2DOI: (10.1016/j.jtcvs.2010.04.029) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Scatter graph illustrating correlation between increasing transplantations and a larger percentage of transplantations performed with a bicaval anastomosis. Patients were divided into 4 groups based on total volume of transplantations performed from 2003 to 2007: (<10 [circles], 10–25 [diamonds], 26–75 [up-pointing triangles], and >75 [down-pointing squares]). Each marker represents a single transplant center and is plotted on the x-axis by the transplant center volume and on the y-axis by the percentage of transplantations performed by using bicaval anastomosis. Horizontal line indicates median percentage of bicaval transplantations performed in each volume group. P = .0344 for correlation between increasing volume and increasing percentage of bicaval transplantations. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 700-708.e2DOI: (10.1016/j.jtcvs.2010.04.029) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Kaplan–Meier estimates of the cumulative hazard of permanent pacemaker insertion after transplantation. Eight-year estimates are illustrated as a function of the type of transplant anastomosis: CAVAL, Bicaval anastomosis; ATRIAL, biatrial anastomosis; TOTAL, total heterotopic transplant anastomosis. Numbers of subjects at risk at each time point are given across the bottom, and standard errors are shown by the dashed lines. P < .0001 (caval vs atrial). The Journal of Thoracic and Cardiovascular Surgery 2010 140, 700-708.e2DOI: (10.1016/j.jtcvs.2010.04.029) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Kaplan–Meier estimates of cumulative long-term survival after transplantation. Ten-year estimates are illustrated as a function of the type of transplant anastomosis: CAVAL, bicaval anastomosis; ATRIAL, biatrial anastomosis; TOTAL, total heterotopic transplant anastomosis. Numbers of subjects at risk at each time point are given across the bottom. P = .0345 (caval vs atrial). The Journal of Thoracic and Cardiovascular Surgery 2010 140, 700-708.e2DOI: (10.1016/j.jtcvs.2010.04.029) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions