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S28 Heart, Lung and CirculationPoster Presentations 2008;17S:S4–S53

poor outcome was correlated with pathological Q waves inpreoperative ECG and with an increased left ventricularend-systolic volume index (>100 ml/m2). The presence ofextensive reversible defects on preoperative thallium-201scintigraphy is a strong predictor of postoperative recov-ery of myocardial function. A poor outcome of surgery canbe expected in the presence of pathological Q waves on thepreoperative ECG or when the left ventricular end systolicvolume index exceeds 100 ml/m2.

doi:10.1016/j.hlc.2007.11.069

Cardiac transplantation

Yogesh Kumar

Cardiac transplantation is the replacement of a person’sfailing heart with a healthy heart from an organ donor.Cardiac transplant may be the only treatment option forpatients who have heart failure caused by:

• Cardiomyopathy;• Viral infections;• Prolonged high blood pressure;• Heart attack; or• Coronary artery disease.

In rare cases, heart transplants are performed onpatients who have valvular heart disease or congenital

• Medications to help counteract the side effects of theimmunosuppressants, such as antacids, diuretics, andantihypertensives.

doi:10.1016/j.hlc.2007.11.070

Dynamics of heart failure and left ventricular parame-ters in patients with nonacute coronary artery disease andrecurrent ischaemia after percutaneous revascularization

Vadim Kuznetsov ∗, Grigoriy Kolunin, Igor Zyrianov,Albert Panin, Dmitriy Krinochkin, Marina Bessonova,Elena Gorbatenko

Tyumen Cardiology Center, Russia

Successful percutaneous revascularization (PR) mayimprove left ventricular (LV) function, remodelling anddiminish severity of heart failure (HF) in patients withnonacute coronary artery disease (CAD). But dynamics ofHF and LV parameters in patients after PR with recurrentischaemia remain unclear.

Aim: To assess and compare dynamics of HF and LVparameters in patients with nonacute CAD after PR hav-ing recurrent ischaemia and patients with nonacute CADreceived conservative therapy.

We examined 141 patients with nonacute CAD beforeand 1–87 months (mean 16 ± 14.6) after angiographicallysuccessful PR and signs of recurrent ischaemia: 57 with

heart disease.Heart transplant recipients must take immunosuppres-

sant medication for the rest of their lives and undergofrequent examinations.

At the transplant centre, the recipient will undergo aseries of tests to ensure that he or she is in satisfactorycondition to receive the donor organ, including:

• Blood tests;• Urine tests; and• Chest X ray.

The procedure is performed under general anaesthesia.To begin the operation, the surgeon performs a ster-

notomy and accesses the heart. The patient is connectedto a heart–lung machine, which stops blood from circu-lating through the coronary arteries when the surgeon isworking on the heart itself.

Surgeons will then remove the patient’s failing heart bymaking incisions in the atria, aorta, and pulmonary arter-ies. The surgeon then connects the donor heart’s bloodvessels to the patient’s. At this point, the heart either startsbeating on its own or receives a shock to restart it. Once thenew heart is beating without support from the heart–lungmachine, the patient is weaned from the machine and thechest will be closed. The procedure takes between 3 and5 h to complete.

Post treatment guidelines and care:Transplant patient should follow these medication for

the rest of his or her life:

• Immunosuppressants;• Antibiotics; and

angiographic restenosis of a target vessel (group 1A) and84 without (group 1B) and 83 patients with nonacute CADreceived conservative medical therapy (group 2). Groupswere matched for age, sex, cardiovascular risk factors andduration between first and second examinations.

Results: The prevalence of patients with more severe HF(II–IV classes NYHA) increased significantly in group 2only (from 53 to 71%, p = 0.007) and was unchanged ingroups 1A and 1B. According to echocardiographic data ingroup 2 LV ejection fraction decreased (from 54.7 ± 7.7 to51.5 ± 9.2%, p = 0.003), LV end diastolic diameter increased(from 50.8 ± 3.5 to 52.1 ± 4.5 mm, p = 0.029) as well as theextent of LV wall motion abnormalities (from 17 ± 14.5 to21.3 ± 16.9%, p = 0.024). Those parameters did not changesignificantly in group 1A. In group 1B LV ejection frac-tion increased (from 53.4 ± 7.9 to 55.3 ± 6.8%, p = 0.015), LVend diastolic diameter and the extent of LV wall motionabnormalities were unchanged.

Conclusion: There were no negative dynamics of HF andLV parameters in patients with nonacute CAD havingrecurrent ischaemia after PR even with restenosis of atarget vessel.

The dynamics of HF and LV parameters severity wereworse in CAD patients received conservative medical ther-apy compared to patients with recurrent ischaemia afterPR.

doi:10.1016/j.hlc.2007.11.071