[Right ventricular insufficiency in patients in the early periods after orthotopic transplantation of donor heart].
The function of transplanted heart in the early postoperative period is analyzed in 20 patients operated on at the Research Center of Surgery of the Russian Academy of Medical Sciences. Cardiac function was assessed by a complex of hemodynamic parameters, among which were the ratio between the ventricular stroke index and end diastolic pressure in the ventricle. Right-ventricular dysfunction of varying severity was detected in all the patients in the immediate postoperative period. Three variants of right-ventricular insufficiency were singled out: isolated right-ventricular insufficiency with increased (20%) and normal (45%) total vascular resistance and right-ventricular insufficiency combined with left-ventricular insufficiency (35%). Isolated right-ventricular insufficiency could be, as a rule, treated by combined intensive care including sympathomimetics and vasodilators. A combination of right-ventricular and left-ventricular insufficiency, which may be caused by incompatability between the sizes of the donor and recipient, as well as hypoxic and metabolic cardiac injury in donor body, is prognostically infavorable, for it requires intensive inotropic therapy and is associated with a high mortality.
Eremenko
A A
AA
Lebedeva
R N
RN
Zhigareva
E Iu
EIu
Chaus
N I
NI
D000328:Adult; D004562:Electrocardiography; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000209:etiology / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000209:etiology* / Q000503:physiopathology
Pravozheludochkovaia nedostatochnost' u patsientov v rannie sroki posle ortotopicheskoĭ transplantatsii donorskogo serdtsa.