SURVIVAL OF ACUTE INTESTINAL INFARCTION AFTER CARDIAC TRANSPLANTATION

We report the case of a 52-year-old male who underwent total orthotopi c heart transplantation for end-stage ischemic cardiomyopathy. The pos toperative course was complicated by acute intestinal infarction which was diagnosed after surgical exploration, and treated with a subtotal colectomy with Brooke ileostomy and closure of the distal sigmoid thr ee days posttransplant. The patient survived with nutritional support and broad antibiotic prophylaxis. Review of the literature on acute ab dominal complications after operations involving cardiopulmonary bypas s suggests that such complications are usually fatal. Detection and di agnosis may be obscured and treatment complicated by immunosuppression after cardiac transplantation. Because of the poor prognosis without appropriate management, a high level of suspicion, early and aggressiv e diagnostic measures, and swift surgical intervention are essential t o survival.