[Association between preoperative pulmonary hypertension and postoperative right ventricular function in heart transplant patients].
OBJECTIVE
To observe the relationship between preoperative pulmonary artery pressure and postoperative right ventricular function in heart transplant patients.


METHODS
A total of 54 heart transplant patients were divided to two groups: group I (n = 34): preoperative pulmonary arterial systolic pressure (sPAP) > or = 45 mm Hg (1 mm Hg = 0.133 kPa) [(60 +/- 12) mm Hg]; group II (n = 20): sPAP < 45 mm Hg [(25 +/- 9) mm Hg]. Cardiac index (CI), pulmonary circulation resistance (PVR) and CVP were measured preoperatively and up to 60 hours post operation by Swan-Ganz catheter. The extent of tricuspid regurgitation at preoperation and 3, 7, 14, 21, 30 days post operation was evaluated by bedside echocardiography. Postoperative pulmonary hypertension was treated by diuresis, nitrates, Ilomedin 20 and hemofiltration (CRRT).


RESULTS
All patients survived the operation. Preoperative PVR was significantly higher in group I patients than that of group II patients [(358 +/- 150) dyn x s(-1) x cm(-5) vs. (140 +/- 68) dyn x s(-1) x cm(-5), P < 0.01]. Right heart insufficiency early post operation was more often in group I patients than that in group II patients (70.6% vs. 35.0%, P < 0.05). The PVR was higher and tricuspid regurgitation extent severer in group II than group I early post operation and were similar 30 days post operation.


CONCLUSIONS
Post operative right heart insufficiency was associated to preoperative pulmonary hypertension in heart transplant patients.
Liu
Ping
P
Department of Cardiovascular Surgery, Cardiovasculae Institute and Fu Wai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China.
Hu
Sheng-Shou
SS
Song
Yun-Hu
YH
DU
Juan
J
D000328:Adult; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D014262:Tricuspid Valve Insufficiency / Q000209:etiology / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000209:etiology / Q000503:physiopathology*