Preoperative evaluation improves the outcome in heart transplant recipients with pulmonary hypertension--retrospective analysis of 106 cases.
Transplant Proc
; 42(9): 3708-10, 2010 Nov.
Article
em En
| MEDLINE
| ID: mdl-21094843
ABSTRACT
OBJECTIVES:
The objectives of this study were to retrospectively analyze the value of preoperative evaluation and to analyze the risk factors of long-term mechanical ventilation in heart transplant recipients.METHODS:
We analyzed the data of 106 patients prepared to receive heart transplants. Before the operation, according to the pulmonary vascular resistance (PVR) and transpulmonary gradient (TPG), the patients were divided into 2 groups a pulmonary hypertension (PH) group and a pulmonary artery pressure normal (N) group. The vasodilator conditioning test as a predictive factor was performed in the PH group. Univariate analysis and logistic regression were used to examine the relationship between risk factors and long-term mechanical ventilation. The 30-day and long-term survival rates were followed.RESULTS:
PVR and TPG significantly decreased among the PH group after intravenous infusion epoprostenol and inhalation (nitric oxide). After preoperative evaluation, 96 patients underwent heart transplantation. There were no short-term deaths related to PH. There was no significant difference in mortality between the PH group and the N group. PH, hypotension after cardiopulmonary bypass, renal dysfunction, donor heart ischemia time, and ejection fraction <25% were risk factors for long-term mechanical ventilation. PH was not related to long-term deaths.CONCLUSION:
A vasodilator conditioning test was reliable for PH patients undergoing heart transplantation for preoperative evaluation and preparation.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Vasodilatadores
/
Transplante de Coração
/
Insuficiência Cardíaca
/
Hipertensão Pulmonar
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article