McNamara N, Narroway H, Williams M Contemporary outcomes of continuous-flow left ventricular assist devices-a systematic review. Ann Cardiothorac Surg. 2021; 10:186-208 https://doi.org/10.21037/acs-2021-cfmcs-35
Little JW, Rhodus NL Dental management of the heart transplant patient. Gen Dent. 1992; 40:126-131
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Cao Y, Chen X, Jia Y Oral health status of adult heart transplant recipients in China: a cross-sectional study. Medicine (Baltimore). 2018; 97 https://doi.org/10.1097/MD.0000000000012508
Habib G, Lancellotti P, Antunes MJ 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015; 36:3075-3128 https://doi.org/10.1093/eurheartj/ehv319
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Meechan JG, Parry G, Rattray DT, Thomason JM Effects of dental local anaesthetics in cardiac transplant recipients. Br Dent J. 2002; 192:161-13 https://doi.org/10.1038/sj.bdj.4801323
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Assistant Professor and Consultant of Conscious Sedation and Special Care Dentistry, Department of Basic and Clinical Oral Science, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
Consultant and Honorary Senior Lecturer in Special Care Dentistry; Clinical Lead, Department of Sedation and Special Care Dentistry, Guy’s and St Thomas’ NHS Foundation Trust, London
The number of cardiac transplants carried out each year within the UK is increasing. With this rise in numbers, it is important that dental professionals are aware of both pre- and post-operative considerations for these patients. This paper considers the practical elements of managing these patients, outlining important aspects of history taking, treatment planning, and safe pain and anxiety management options.
CPD/Clinical Relevance:
The unilateral sagittal split osteotomy may present an alternative method for removing impacted mandibular third molar teeth in certain situations.
Article
Cardiac transplantation replaces a non-functioning heart with a healthy heart from a recently deceased donor.1 It is performed in those with end-stage heart failure or those with life threatening arrythmias when other medical or surgical treatments have failed.2
Annually, around 200 cardiac transplants are performed in the UK, with 5-year adult survival rates of approximately 71%.1
Those waiting for a cardiac transplant are assigned to either a super-urgent, urgent or non-urgent (routine) heart transplant list. The median waiting time on a non-urgent list is 2189 days, on an urgent list is 37 days, and on a super-urgent list it is 10 days.3 Those waiting for a donor may be offered a ventricular assist device (VAD). These are battery-operated pumps surgically implanted into the heart's left ventricle to partially or completely replace cardiac function. Although results are variable, 12-, 24- and 48-month survival rates with VADs are reported as 82%, 72% and 57%, respectively.4
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