RESUMO
Se presentan los primeros cinco casos de trasplante de corazón-pulmón en el Hospital de la Beneficiencia Portuguesa de Sao Paulo, Brasil. El programa se inicio en diciembre de 1988; se analizan los resultados de esta experiencia preliminar. Uno de los pacientes sufría cardiomiopatía con elevada resistencia pulmonar, dos tenían hipertensión pulmonar primaria y el cuarto silicosis pulmonar. El bloque cardiopulmonar donante fue rescatado utilizando circulación extracorpórea e hipotermina profunda, y fue trasplantado al receptor anastomosando la tráquea, la aurícula derecha o las venas cavas y la aorta ascedente.
Assuntos
Transplante de Coração-Pulmão , Cardiomiopatias , Hipertensão PulmonarRESUMO
Purpose To assess this initial clinical experience with heart-lung transplantation in Brazil. Methods Four patients underwent heartlung transplantation from December 1988 to March 1990, one patient with cardiomyopathy and high pulmonary resistance, two patiens with primary pulmonary hypertension and another with pulmonry silicosis. The heart lung blocks were harvestedfrom the donor using cardiopulmonary bypass and deep hypotermia. They were transplanted to the recipient by anastomosing the tracheae, right atrium or venae cavae, and the ascending aorta. Results The second patient died on the 5th postoperative day due to respiratory insuffciency with consequent brain lesions. The first and third patients had survived nine manths and 42 days respectively. The 4th patients is assymptomatic eight months after the operation. The main complications were bleeding in two patients, acute pulmonary rejection in three of them and obliterans bronchiolitis in one patients. Conclusion The heart lung transplantation is a challenging procedure which results are progressively improving with the development of better surgical technique and clinical concepts.
