Is severe pulmonary hypertension a contraindication for orthotopic heart transplantation? Not any more.

Abstract:

:Pulmonary hypertension (PH) unresponsive to pharmacological intervention is considered a contraindication for orthotopic heart transplantation (OHTX) due to risk of postoperative right-heart failure. In this prospective study, we describe our experience with a treatment strategy of improving severe PH in heart transplant candidates by means of ventricular assist device (VAD) implantation and subsequent OHTX. In 11 heart transplantation candidates with severe PH unresponsive to pharmacological intervention we implanted VAD with the aim of achieving PH to values acceptable for OHTX. In all patients we observed significant drop in pulmonary pressures, PVR and TPG (p < 0.001 for all) 3 months after VAD implantation to values sufficient to allow OHTX. Seven patients underwent transplantation (mean duration of support 216 days) while none of patients suffered right-side heart failure in postoperative period. Two patients died after transplantation and five patients are living in very good condition with a mean duration of 286 days after OHTX. In our opinion, severe PH is not a contraindication for orthotopic heart transplantation any more.

journal_name

Physiol Res

journal_title

Physiological research

authors

Kettner J,Dorazilová Z,Netuka I,Malý J,Al-Hiti H,Melenovský V,Skalský I,Říha H,Málek I,Kautzner J,Pirk J

doi

10.33549/physiolres.932158

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

769-75

issue

5

eissn

0862-8408

issn

1802-9973

pii

932158

journal_volume

60

pub_type

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