complication | Acta Medica Marisiensis

Introduction: New onset diabetes mellitus in patients with heart transplant is a known complication with importance in the long term survival.
Material and methods: We have studied the incidence of new onset diabetes in a group of 38 patients with heart transplant that are included database of Emergency Institute of Cardiovascular Diseases and Transplantation, Tîrgu Mureș, between 1999–2011.
Results: The incidence of new onset diabetes was of 24.32% in the 1st month of posttransplant evolution, 22.58% at 1 year of evolution, 18.18% at 3 years of evolution and 10% at 5 years of posttransplant evolution. We have studied these posttransplant complications in relation with the risk factors and the most important complications in the evolution of these patients.
Conclusions: New onset diabetes in heart transplant recipients is a serious complication with high incidence and with serious implications in their evolution, requiring an accurate screening of the recipients in the waiting list and a periodical posttransplant evaluation, an early detection and a prompt and efficient treatment.

Background: A standard technique regarding venous approach for implantation of biventricular cardiac electrical devices used for cardiac resynchronization therapy implementation has not yet been established. We analyzed the safety and efficiency of implanting these devices using a double venous approach (cephalic and subclavian) by comparing it with the simple approaches, in order to overcome some of their inconvenients.
Materials and methods: We retrospectively analyzed all 228 resynchronization patients implanted at the Timișoara Institute of Cardiovascular Medicine between January 1st, 2000 and January 1st, 2013. The 204 patients successfully implanted with biventricular pacemakers or defibrillators were divided according to the implantation techniques, and compared by complication rates and values of acute stimulation-detection thresholds. Group A featured a subclavian approach (48 patients), group B a cephalic approach (81 patients) and group C a double venous approach (76 patients).
Results: Adjusting for age, sex and device type there is no evidence in the data that complication rates are significantly different when using the different techniques: 6 complications (12.5%) in group A, 8 (9.87%) in group B and 5 (6.75%) in group C (p = 0.51). A slight downward trend was observed by using double venous approach. Values of acute stimulation-detection thresholds had no statistically significant differences neither (p = 0.36). Cephalic vein was of high quality in 59.8% of cases.
Conclusions: Subclavian and cephalic double venous approach implantation technique for biventricular devices proved to be feasible and at least as safe as single venous approach using subclavian or cephalic vein alone, and it can be used as a first resort technique.