title: Preoperative evaluation improves the outcome in heart transplant recipients with pulmonary hypertension--retrospective analysis of 106 cases.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  A vasodilator conditioning test was reliable for PH patients undergoing heart transplantation for preoperative evaluation and preparation.
authors.affiliation: Department of Anesthesiology, Shanghai 6th People's Hospital Affiliated to Jiaotong University, Shanghai, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Zeng
authors.forename: Z
authors.initials: Z
authors.lastname: Jiang
authors.forename: C S
authors.initials: CS
authors.lastname: Wang
authors.forename: H
authors.initials: H
authors.lastname: Luo
authors.forename: Y F
authors.initials: YF
authors.lastname: Huang
authors.forename: X H
authors.initials: XH
authors.lastname: Jin
mesh_terms: D000328:Adult; D001794:Blood Pressure; D016009:Chi-Square Distribution; D002681:China; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011651:Pulmonary Artery / Q000503:physiopathology; D012121:Respiration, Artificial / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014655:Vascular Resistance; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents