156: Hypercholesterolemia in Heart Transplant Patients on Proliferation-Signal Inhibitors: Is Statin Therapy Effective?

various cardiac operations. We initiated a study to determine feasibility and safety of IE in orthotopic heart transplantation (OHT). Methods and Materials: From 1/2004 to 5/2007 a protocol was implemented with intention to perform IE in OHT. A retrospective analysis of 34 preoperative and 10 intraoperative variables was performed to identify factors leading to IE and outcomes were analyzed for safety. Results: 42 of 90 (46.7%) consecutive patients undergoing OHT by a single anesthesiologist underwent IE. Preoperative variables associated with IE included first operation, non-ischemic etiology and Status IB/2. Intraoperative factors associated with IE included shorter surgical (244 67vs.342 167 min,p 0.001) and cardiopulmonary bypass (138 35vs.164 48 min,p 0.005) duration, less use of inotropes and transfusions. On arrival to the ICU, vital signs and blood gases were not clinically different except for a lower arterial oxygen and higher respiratory rate in the non-ventilated patients. Patients not undergoing IE were initially ventilated for 29.4 35.6 hr(median 13.4). Significant complications in the IE group included mortality 0%, stroke 2.3%, septicemia 2.3% renal failure 7% and bleeding 11.6%; none related to IE. Two patients were briefly ventilated after returning to the OR for postoperative bleeding. Patients undergoing IE had shorter ICU (5.4vs.7.7days,p 0.02) and hospital (10.1vs.14.1 days,p 0.03) length of stays. Conclusions: Immediate extubation after OHT by an experienced anesthesiologist is feasible for select patients sparing them the experience of postoperative intubation and ventilation without complications. Further studies are needed to confirm IE safety and identify other advantages.