Pulmonary Hypertension in Heart Failure: Effects of Heart Transplantation

  • R. Naeije
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine 1993 book series (YEARBOOK, volume 1993)

Abstract

Pulmonary hypertension secondary to chronic pulmonary venous hypertension in patients with congestive heart failure may become relatively fixed over time due to structural changes in the pulmonary vasculature [1]. An acute decrease in left atrial pressure (Pia) after cardiac transplantation in these patients may therefore be associated with high pulmonary arterial pressures (Ppa), persistent at levels known to be poorly tolerated by a normal right ventricle [2]. Accordingly, high preoperative pulmonary vascular resistance (PVR) has been found associated with a significant risk of fatal right ventricular (RV) failure after orthotopic cardiac transplantation [3–6]. In order to limit the frequency of this complication, patients with a PVR of more than 480 to 640 dynes.s.cm5 (6 to 8 Wood units) are generally excluded from the potential benefits of the surgical procedure [3–6]. Most recently, testing for a pharmacological reversal of elevated PVR at preoperative evaluation has been reported [6,7], and the results of these manipulations contended to be helpful for the prediction of postoperative pulmonary hemodynamics [6].

Keywords

Pulmonary Hypertension Right Ventricular Pulmonary Vascular Resi Cardiac Transplantation Left Atrial Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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© Springer-Verlag Berlin Heidelberg 1993

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  • R. Naeije

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