(A–C) Heart transplantation as primary treatment for ventricular tachyarrhythmias and heart failure following myocardial infarction
|
(A) Actually transplanted (n = 8) |
| Age/sex | MI-N | First VT present | VTA number | Tx waiting (days) | KC | CADs | LVEF (%) | WMS | CI | Tx (+/−) | F-up (months) | Status |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 52/M | 2 | Arrest | 16 | 44 | II | 2 | 28 | 2 | 2.0 | + | 109 | Alive |
| 51/M | 3 | Arrest | 3 | 92 | II | 2 | 16 | 2 | 2.7 | + | 103 | Alive |
| 51/M | 4 | Arrest | 5 | 111 | III | 2 | 18 | 2 | 1.2 | + | 92 | Alive |
| 42/M | 4 | Tolerated | 24 | 35 | III | 2 | 16 | 1 | 2.7 | + | 56 | Died (MI) |
| 59/M | 1 | Arrest | 10 | 52 | IV | NA | 15 | 0 | 3.1 | + | 54 | Alive |
| 56/M | 2 | Tolerated | 5 | 30 | I | 1 | 15 | 0 | 2.6 | + | 17 | Alive |
| 59/M | 4 | Tolerated | 1 | 28 | I | 3 | 18 | 1 | 1.6 | + | 11 | Alive |
| 60/M | 2 | Tolerated | 1 | 20 | IV | NA | NA | 1 | 2.9 | + | 33 | Alive |
| (B) Died of arrhythmias awaiting transplantation (n = 5) |
| Age/sex | MI-N | First VT present | VTA number | Tx waiting (days to death) | KC | CADs | LVEF (%) | WMS | CI | Tx (+/−) | LV support deployed |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 50/M | 2 | Tolerated | Intractable × 24 h | 2 | IV | 2 | 10 | 0 | NA | − | IABP |
| 38/M | 1 | Tolerated | ⩾ 4 | 7 | II | 1 | NA | 2 | NA | − | PC bypass |
| 62/F | 1 | Arrest | ⩾ 5 | 18 | IV | 2 | 15 | 2 | 2.9 | − | IABP/pacing |
| 59/M | 1 | Tolerated | Intractable | 11 | II | 3 | <25 | 0 | NA | − | IABP/pacing |
| 57/F | 2 | Arrest | Intractable × 48 h | 13 | IV | NA | 26 | NA | NA | − | Dobutamine |
| (C) High risk arrhythmia surgery undertaken (n = 4) |
| Age/sex | MI-N | First VT present | VTA number | Tx waiting (days to death) | KC | CADs | LVEF (%) | WMS | CI | Tx (+/−) | LV support deployed |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 49/M | 1 | Arrest | Incessant | 12 | I | 1 | 235 | 2 | NA | − | IABP + LVAD |
| 54/F | 1 | Tolerated | Incessant | 7 | IV | 1 | 5 | 0 | NA | − | IABP |
| 52/M | 1 | Collapse | 6 | 11 | IV | 1 | 17 | 5 | NA | − | IABP; dopamine |
| 43/M | 1 | Arrest | 7 | 2 | IV | 1 | <10 | 0 | NA | + | LVAD→Tx |
Arrest, cardiac arrest; CADs, number of major coronary arteries with stenoses >75%; CI, cardiac index (l/min/m2); First VT present, clinical presentation of the first arrhythmic episode; F-up, duration of follow up after cardiac transplantation; IABP, intra-aortic balloon pump device; KC, Killip classificication of heart failure (I-IV); LVAD, left ventricular assist device; LVEF, % left ventricular ejection fraction; MI, myocardial infarction; MI-N, number of confirmed myocardial infarctions; NA, data not available; PC bypass, percutaneous cardiopulmonary bypass; Tolerated, haemodynamically tolerated + syncope; Tx (+/−), whether cardiac transplantation performed; WMS, left ventricular segments with normal systolic motion (1–9).