Q: What is the best way to anticipate Right Heart Failure (RHF) in post heart transplant patients?
Answer: If a patient has
is at high risk for RHF after a transplanted heart.
Two considerations are of utmost importance:
1. If a patient has an irreversible severe pulmonary hypertension, combined heart-lung transplantation should be considered.
2. If a patient is on chronically administered pulmonary vasodilator therapy, it should be continued during the pre-bypass period, and such therapies will likely be necessary to achieve separation from cardiopulmonary bypass (CPB) after a heart transplant.
#transplantation
#cardiology
#pulmonary
References:
1. De Santo LS, Romano G, Maiello C, et al. Pulmonary artery hypertension in heart transplant recipients: how much is too much? Eur J Cardiothorac Surg 2012; 42:864.
2. Vakil K, Duval S, Sharma A, et al. Impact of pre-transplant pulmonary hypertension on survival after heart transplantation: a UNOS registry analysis. Int J Cardiol 2014; 176:595.
Answer: If a patient has
- elevated pulmonary artery systolic pressure >50 mmHg,
- elevated PVR >3 Wood units (320 dynes-sec-cm-5) or
- elevated transpulmonary gradient of >15 mmHg,
is at high risk for RHF after a transplanted heart.
Two considerations are of utmost importance:
1. If a patient has an irreversible severe pulmonary hypertension, combined heart-lung transplantation should be considered.
2. If a patient is on chronically administered pulmonary vasodilator therapy, it should be continued during the pre-bypass period, and such therapies will likely be necessary to achieve separation from cardiopulmonary bypass (CPB) after a heart transplant.
#transplantation
#cardiology
#pulmonary
References:
1. De Santo LS, Romano G, Maiello C, et al. Pulmonary artery hypertension in heart transplant recipients: how much is too much? Eur J Cardiothorac Surg 2012; 42:864.
2. Vakil K, Duval S, Sharma A, et al. Impact of pre-transplant pulmonary hypertension on survival after heart transplantation: a UNOS registry analysis. Int J Cardiol 2014; 176:595.
No comments:
Post a Comment