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Diameter of the dilated main pulmonary artery in patients with pulmonary hypertension decreases after lung transplantation

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Abstract

Purpose

The pulmonary artery (PA) in patients with pulmonary hypertension (PH) becomes dilated. We analyzed the postoperative changes of the main PA after lung transplantation (LuTx).

Methods

The subjects of this retrospective study were 68 LuTx recipients, divided into a PH group (n = 36) and a non-PH group (n = 32), based on preoperative right heart catheterization findings. The PA diameter was measured on chest computed tomography. We evaluated the correlation between the mean pulmonary arterial pressure (mPAP) and the main PA diameter and compared the main PA diameters before and 3 months after LuTx.

Results

The main PA diameter was significantly correlated with the mPAP (r = 0.423, P < 0.001). Preoperatively, the mean main PA diameter in the PH group was significantly greater than that in the non-PH group. However, by 3 months after LuTx, the main PA diameter in the PH group had decreased significantly from 32.4 ± 6.7 to 26.9 ± 4.8 mm (P < 0.001), while that in the non-PH group had decreased minimally from 28.3 ± 4.9 to 26.4 ± 4.6 mm (P < 0.001), resulting in no significant difference in postoperative main PA diameters between the two groups.

Conclusions

The main PA diameter in recipients with PH was enlarged and correlated with the mPAP. The dilated main PA diameter in PH patients decreased shortly after LuTx.

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Abbreviations

DDLT:

Deceased donor lung transplantations

COPD:

Chronic obstructive pulmonary disease

CT:

Computed tomography

IPAH:

Idiopathic pulmonary arterial hypertension

LDLLT:

Living donor lobar lung transplantations

LuTx:

Lung transplantation

mPAP:

Mean pulmonary arterial pressure

PA:

Pulmonary artery

PH:

Pulmonary hypertension

PA/Ao ratio:

Ratio of PA to ascending aorta

RHC:

Right heart catheterization

ROC:

Receiver-operating characteristic

AUC:

Area under the ROC curve

95% CI:

95% Confidence interval

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Authors and Affiliations

  1. Department of Thoracic Surgery, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Hidenao Kayawake, Akihiro Aoyama, Hideki Motoyama, Masatsugu Hamaji, Daisuke Nakajima, Toyofumi F. Chen-Yoshikawa & Hiroshi Date

  2. Department of Thoracic Surgery, Kobe City Medical Center General Hospital, 2 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan

    Akihiro Aoyama

  3. Department of Cardiovascular Medicine, Kyoto University, Kyoto, Japan

    Hideyuki Kinoshita

  4. Department of Clinical Laboratory, Kyoto University Hospital, Kyoto, Japan

    Tomoya Yoneda

  5. Department of Pediatrics, Kyoto University, Kyoto, Japan

    Shiro Baba

  6. Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan

    Yuki Teramoto & Aya Miyagawa-Hayashino

  7. Department of Cardiovascular Surgery, Kyoto University, Kyoto, Japan

    Kazuhiro Yamazaki

Authors
  1. Hidenao Kayawake
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  2. Akihiro Aoyama
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  3. Hideyuki Kinoshita
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  8. Kazuhiro Yamazaki
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  9. Hideki Motoyama
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  10. Masatsugu Hamaji
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  12. Toyofumi F. Chen-Yoshikawa
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  13. Hiroshi Date
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Correspondence to Akihiro Aoyama.

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Kayawake, H., Aoyama, A., Kinoshita, H. et al. Diameter of the dilated main pulmonary artery in patients with pulmonary hypertension decreases after lung transplantation. Surg Today 50, 275–283 (2020). https://doi.org/10.1007/s00595-019-01887-6

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  • DOI: https://doi.org/10.1007/s00595-019-01887-6

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