Bosentan treatment in chronic pulmonary venous hypertension with significant right heart dysfunction

Grander, Wilhelm; Eller, P.; Gänzer, Johannes; Tilg, Herbert; Geiger, Ralf

doi:10.1185/030079907x199565

Cited by 1 publication

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“…Diuretics and levosimendan led to a substantial improvement of diastolic left heart function. Our own experience of beneficial effects of pulmonary vascular dilative medical therapy with bosentan in patients with heart failure with a normal ejection fraction with PVH and right ventricular failure [ 19 ] led us to consider the application of an endothelin-1-receptor antagonist in this case. In addition a therapy with epoprostenol, of which beneficial effects on reversibility of pulmonary hypertension in congestive heart failure prior to cardiac transplantation are known, was started [ 8 , 20 – 22 ].…”

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confidence: 99%

Heart Transplantation in a 14-Year-Old Boy in the Presence of Severe Out-of-Proportion Pulmonary Hypertension due to Restrictive Left Heart Disease: A Case Report

Schwienbacher

Schweigmann

Neu

et al. 2013

Case Reports in Cardiology

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A 14-year-old boy after balloon valvuloplasty of severe aortic valve stenosis in the neonatal period was referred for heart-lung transplantation because of high grade pulmonary hypertension and left heart dysfunction due to endocardial fibroelastosis with severe mitral insufficiency. After heart catheterization, hemodynamic parameters were invasively monitored: a course of levosimendan and initiation of diuretics led to a decrease of pulmonary capillary wedge pressure (from maximum 35 to 24 mmHg). Instead of an expected decrease, mean pulmonary artery pressures (mPAP) increased up to 80 mmHg with increasing transpulmonary pressure gradient (TPG) up to 55 mmHg. Oral bosentan and intravenous epoprostenol then led to a ~50% decrease of mPAP (TPG between 16 and 22 mmHg). The boy was listed solely for heart transplantation which was successfully accomplished 1 month later.

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