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Prognosis of altern...
Prognosis of alternative therapies in patients with heart failure not accepted for heart transplantation.
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Lindelöw, B (författare)
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- Andersson, Bert, 1952 (författare)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Hjärt-kärlinstitutionen,Wallenberg Laboratory,Cardiovascular Institute
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- Waagstein, Finn, 1938 (författare)
- Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Wallenberglaboratoriet,Cardiovascular Institute,Wallenberg Laboratory
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visa fler...
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- Bergh, Claes-Håkan, 1951 (författare)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Hjärt-kärlinstitutionen,Wallenberg Laboratory,Cardiovascular Institute
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visa färre...
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(creator_code:org_t)
- 1995
- 1995
- Engelska.
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Ingår i: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. - 1053-2498. ; 14:6 Pt 1, s. 1204-11
- Relaterad länk:
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https://gup.ub.gu.se...
Abstract
Ämnesord
Stäng
- This article describes the outcome of alternative therapies in patients with end-stage heart failure, New York Heart Association class III-IV, referred for heart transplantation evaluation but not accepted for the procedure. From January 1988 through September 1992, 233 consecutive patients with severe heart failure were admitted to the thoracic transplantation center at Sahlgrenska University Hospital. At the time of admission all patients received standard medical treatment for heart failure. During the pretransplantation evaluation, an attempt to optimize the medical therapy was made in all patients.Eighteen patients (8%) died before a decision concerning transplantation was made, and 146 patients (63%) were accepted for heart transplantation. There were 69 patients (30%) who were denied heart transplantation for various reasons, and they were subgrouped: patients with contraindications (group 1, n = 23) or without indication (group 2, n = 10) for heart transplantation, patients with a positive response to intensified medical therapy (group 3, n = 25), and patients who underwent coronary artery bypass grafting and/or valvular heart surgery (group 4, n = 11). The 1-, 3-, and 5-year actuarial survival rates were as follows: group 1, 26%, 16%, and 8%; group 2, 100%, 77%, and 39%; group 3, 96%, 67%, and 53%; and group 4, 64%, 36%, and 27%, respectively. The corresponding figures for patients who had a heart transplantation were 85%, 79%, and 75%, respectively. During the first 2 to 3 years of follow-up the survival of group 2 and group 3 patients was similar to that of patients who underwent transplantation. However, late survival was worse compared with the heart transplant group.These results suggest that by close follow-up it may be possible to postpone heart transplantation in a selected group of patients.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Adult
- Aged
- Cardiotonic Agents
- administration & dosage
- adverse effects
- Contraindications
- Coronary Artery Bypass
- Exercise Test
- Female
- Follow-Up Studies
- Heart Failure
- mortality
- physiopathology
- therapy
- Heart Transplantation
- Heart Valve Prosthesis
- Hemodynamics
- drug effects
- physiology
- Humans
- Male
- Middle Aged
- Survival Rate
- Treatment Outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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