Maria Arraiza MD, Presenter: Nothing to Disclose

Gorka Bastarrika MD, Abstract Co-Author: Nothing to Disclose

Beatriz Zudaire MD, Abstract Co-Author: Nothing to Disclose

Javier Arias MD, Abstract Co-Author: Nothing to Disclose

Alberto Villanueva, Abstract Co-Author: Nothing to Disclose

Gregorio Rabago, Abstract Co-Author: Nothing to Disclose

In orthotopic heart transplant (OHT) recipients the bicaval surgical technique may produce more physiologic atrial contraction than the standard biatrial anastomosis, approaching the performance of normal atria. The aim of this study was to assess left atrial (LA) function and volumes in OHT recipients operated with standard and bicaval anastomotic techniques and compare these parameters with those of normal subjects.

Forty-two consecutive OHT recipients (27 bicaval, 15 standard) and sixteen non-transplanted individuals underwent dual-source CT (DSCT) coronary angiography to rule out coronary allograft vasculopathy and coronary artery disease, respectively. Two independent observers manually traced LA contours on axial 5-mm slice thickness multiphase reconstructions at 5% steps (0-95% of the cardiac cycle). End-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) were compared in all individuals using the Kruskal-Wallis test. Pair-wise comparison allowed estimating differences between surgical techniques and with respect to non-transplanted subjects.

In OHT recipients statistically significant differences were observed for all LA parameters (p<0.01). Individuals operated with the bicaval technique presented significantly lower EDV (mean difference:117.2±50.1 ml) and ESV (mean difference:114.5±48.7 ml), and higher EF (mean difference:8.2±2.2%) than patients undergoing standard biatrial anastomosis (p<0.05). Differences in LA parameters were also statistically significant between OHT recipients operated with the more physiological bicaval technique and non-transplanted subjects for ESV (mean difference:23.7±12.7 ml) and EF (mean difference:17.7±2.9%) but not for EDV (mean difference:6.1±12.6 ml).

Bicaval anastomosis offers improved LA performance compared with the standard biatrial technique but still differs from normal LA volumes and function.

DSCT allows evaluating left atrial volumes and function in OHT recipients.

Arraiza, M, Bastarrika, G, Zudaire, B, Arias, J, Villanueva, A, Rabago, G, Left Atrial Performance in Orthotopic Heart Transplant Recipients Operated with the Standard or Bicaval Technique with Respect to Normal Individuals: A Comparative Study Using Dual-Source CTP.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8015341.html