Stroke versus non-stroke neurological complications after cardiac transplant (P4.299)

Objective: To describe the neurological complications after CT, with special interest in addressing CVD and to analyze its associated risk factors. Background: Cardiac transplant (CT) is a gold standard therapy for end-stage heart failure. Neurological complications represent one of the most important sources of morbidity in successful transplants. Cerebrovascular diseases (CVD) are a main subgroup of neurological complications with pre and perioperative risk factors. Design/Methods: We retrospectively evaluated the medical records of patients who underwent CT and developed neurological complications (NCACT) between 2006 and June 2016. Categorization of the sample of patients with NCACT into: those with stroke and those with non-strokeneurological complications (nS-NC). We analyzed pre-transplant risk factors: vascular risk factors, history of stroke, carotid stenosis, left atrial enlargement, type of miocardiopathy; as well as the peri-surgery variables: hemodynamic instability, cardiopulmonary arrest, extracorporeal circulation longer than 120 minutes. Prognostic outcomes were event time and in-hospital mortality. Results: Over 279 patients with CT in this period, 67 developed neurological complications (24%). 55 patients with nS-NC, described as: epilepsy 18, encephalopathies 15, CNS infection 5, PRESS 5, neuropathies 4, headache 4, and others, 12 (4.3%) patients had stroke: 9 ischemic and 3 hemorrhagic. Time to complication after CT was significantly longer for the nS-CN, considering its occurrence both in the first week as well as after 30 days. In the comparative analysis of patients with stroke and nS-CN, only ischemic cardiomyopathy was significantly more frequent in patients with stroke; other variables showed no significant difference. Conclusions: Neurological complications after CT in our population reach nearly a quarter of patients, similar to or even lower than in previous studies. 4.3% of patients developed stroke, ischemic subtype. Pre- and perioperative variables do not differ between both groups, except from ischemic cardiomyopathy as the cause of heart failure being it more frequent in the stroke group. Disclosure: Dr. Vazquez has nothing to disclose. Dr. Thomson has nothing to disclose. Dr. Molina Melendres has nothing to disclose. Dr. Nadile has nothing to disclose. Dr. Gonzalez Toledo has nothing to disclose. Dr. Claverie has nothing to disclose. Dr. Thomson has nothing to disclose. Dr. Peradejordi has nothing to disclose. Dr. Couto has nothing to disclose. Dr. Favaloro has nothing to disclose. Dr. Favaloro has nothing to disclose. Dr. Bertolotti has nothing to disclose. Dr. Klein has nothing to disclose.