TY - CHAP M1 - Book, Section TI - Cardiac Transplantation A1 - Liao, Kenneth K. A1 - Shumway, Sara J. A2 - Yuh, David D. A2 - Vricella, Luca A. A2 - Yang, Stephen C. A2 - Doty, John R. PY - 2014 T2 - Johns Hopkins Textbook of Cardiothoracic Surgery AB - EpidemiologyHeart failure increases as the population ages and becomes increasingly obese. It can be acute or chronic, and systolic or diastolic.PathophysiologyHeart failure may result from untreated hypertension or a myocardial infarction. Viruses may have caused idiopathic dilated cardiomyopathies. Hypertrophic cardiomyopathy is less common. Infiltrating cardiomyopathies also occur.Clinical featuresLeft-heart failure is manifested by shortness of breath, cough, and fatigue. Right-heart failure is responsible for right upper quadrant abdominal discomfort from a congested liver and peripheral edema. Ascites occurs later.DiagnosticsPatient with heart failure are evaluated by echocardiography, and right and left cardiac catheterization. Coronary angiography is still the gold standard for evaluating coronary artery disease.Treatment (medical/surgical)Heart transplantation is reserved for patients who are failing medical management and are not thought to have a life expectancy of greater than 2 years. It can be done after the patient has been bridged with a left ventricular assist device (LVAD).Outcomes/prognosisThe median survival after cardiac transplantation is 10 years. The mortality rate after 1 year is 3 to 4 percent/year. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/13 UR - accesssurgery.mhmedical.com/content.aspx?aid=1104593214 ER -