Successful cardiac transplantation in a patient with elevated pulmonary vascular resistance: a relative contraindication to transplantation.
Elevated pulmonary vascular resistance in a transplantation candidate should be viewed as potentially reversible, and there are several options for therapy. We describe a young patient with congenital restrictive cardiomyopathy and a markedly elevated pulmonary artery pressure. The patient underwent successful orthotopic heart transplantation after pharmacologic lowering of the pulmonary artery pressure with a new drug combination of milrinone and nesiritide. The length of therapy can be extended to 3 days to allow for determining the pulmonary vascular responsiveness.
Morris
Cullen D
CD
Department of Cardiopulmonary Transplantation and Mechanical Circulatory Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas, USA.
Smith
Ron D
RD
Kar
Biswajit
B
Ghodsizad
Ali
A
Reverdin
Stephane
S
Frazier
O H
OH
Gregoric
Igor D
ID
D000293:Adolescent; D009202:Cardiomyopathies / Q000150:complications* / Q000601:surgery*; D000075202:Contraindications; D006333:Heart Failure / Q000209:etiology* / Q000517:prevention & control*; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000601:surgery*; D008297:Male; D009634:Noonan Syndrome / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome