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Right Ventricular Dysfunction Post-Heart Transplantation

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Right Ventricular Physiology, Adaptation and Failure in Congenital and Acquired Heart Disease

Abstract

Right ventricular dysfunction is prevalent following orthotopic heart transplantation. The sequential insults of donor brain death, cardioplegia, ischemia, reperfusion injury and cardiopulmonary bypass interact together with raised recipient pulmonary vascular resistance to produce this common complication. Early recognition is important because the principles of management, which hinge on avoiding volume overload, inappropriate inotropic support, and the maintenance of adequate blood pressure to maintain coronary perfusion, differ substantially from other forms of acute heart failure. With improved management, and in particular, the availability of selective pulmonary vasodilators and advances in mechanical circulatory support, the prognosis has improved considerably within the last two decades.

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Authors and Affiliations

  1. Department of Cardiology, The Royal Children’s Hospital, Melbourne, Australia

    Jacob Mathew

  2. Paediatric Cardiology, Labatt Family Heart Centre, Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada

    Anne I. Dipchand

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  1. Paediatric Cardiology, Labatt Family Heart Center Hospital for Sick Children, Toronto, Ontario, Canada

    Mark K. Friedberg

  2. Heart Institute, Cincinnati Children’s Hosp Med Center, Cincinnati, Ohio, USA

    Andrew N. Redington

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Mathew, J., Dipchand, A.I. (2018). Right Ventricular Dysfunction Post-Heart Transplantation. In: Friedberg, M., Redington, A. (eds) Right Ventricular Physiology, Adaptation and Failure in Congenital and Acquired Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-67096-6_15

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