title: Farmacologic pre implants test in high pulmonary hypertension and still in candidates for heterotopic transplantation.
abstract: BACKGROUND
  Evaluation of pulmonary artery pressure just before transplanting with sodium nitroprusside may allow conversion to orthotopic technique.
  
  
  METHODS
  Between 1992 and 2007, 228 transplants were performed systematically and this was used in seven patients with preoperative hemodynamic evaluation: Pre NP (mmHg) Post NP (mmHg) Systolic systemic blood pressure (PSAS) 108-78 (101.7 ± 10.9) 90-74 (79.5 ± 15.2) pulmonary arterial systolic pressure (PASP) 88-51 (69.8 ± 13.2) 70-40 (57.8 ± 9.9) Gradient transpulmonary (GTP) 16-11 (14.2 ± 1.7) 14-11 (12.4 ± 1.2) pulmonary vascular resistance (PVR/w) 7.9 to 4.8 (6.2 ± 1 0) 5.9-4.1 (5.0 ± 0.8).
  
  
  RESULTS
  The intraoperative findings were: Pre NP (mmHg) e Post NP (mmHg), respectively, PSAS 91-78 (8.5 ± 5.2) and 65-59 (4.2 ± 63.8) (P = 0.017), decrease 19.9%, decrease 29.3%; PSAP 71-52 (61.8 ± 6.1) and 43-32 (37.5 ± 3.3) (P = 0.018), decrease 28%, decrease 41%. In light of these data, patients were transplanted by orthotopic technique not being observed mortality in the short and long-term evolution from 5 months to 6 years.
  
  
  CONCLUSIONS
  This methodology allowed the conversion of the technique for heterotopic orthotopically, with good early and late outcomes.
authors.affiliation: FMUSP, Medical Transplants Section, Instituto Dante Pazzanese de Cardiologia/SP, São Paulo, Brazil. j.dinkhuysen@uol.com.br
authors.forename: Jarbas Jakson
authors.initials: JJ
authors.lastname: Dinkhuysen
authors.forename: Reginaldo
authors.initials: R
authors.lastname: Cipullo
authors.forename: Carlos
authors.initials: C
authors.lastname: Contreras
authors.forename: Marco Aurélio
authors.initials: MA
authors.lastname: Finger
authors.forename: Ricardo
authors.initials: R
authors.lastname: Manrique
authors.forename: Helio M
authors.initials: HM
authors.lastname: Magalhães
authors.forename: Paulo
authors.initials: P
authors.lastname: Chaccur
authors.forename: João
authors.initials: J
authors.lastname: Rossi
mesh_terms: D000293:Adolescent; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000601:surgery*; D005260:Female; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009599:Nitroprusside / Q000627:therapeutic use*; D016019:Survival Analysis; D016042:Transplantation, Heterotopic; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D009599:Nitroprusside