Lung transplantation for pulmonary hypertension with giant pulmonary artery aneurysm

Schwarz, Štefan; Benazzo, Alberto; Prosch, Helmut; Jaksch, Péter; Klepetko, Walter; Höetzenecker, Konrad; Moser, Bernhard; Matilla, José Ramon; Láng, György; Taghavi, Shahrokh

doi:10.1016/j.jtcvs.2019.09.178

Cited by 18 publications

(18 citation statements)

References 26 publications

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“…Their institutional experience with a lung-only strategy, where donor PA trunk was procured along with the lungs, and the main PA was reconstructed along with the implantation of the right lung. The left lung was then implanted and the left PA was reconnected to the main PA. Their series demonstrates feasibility of this approach in this complex group of patients [19]. Shayan et al reported a case where the donor pulmonary trunk was procured with the lungs [20].…”

Section: Discussionmentioning

confidence: 98%

Surgical Management of Giant Pulmonary Artery Aneurysm in Patients with Severe Pulmonary Arterial Hypertension

Gajera

Doi

Niewodowski

et al. 2021

Preprint

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Patients with pulmonary arterial hypertension (PAH) may develop large pulmonary artery aneurysms (PAA) which may be complicated by rupture, dissection or intravascular thrombus formation. These patients were traditionally considered for heart-lung transplantation but more recently, there have been reports of successful lung transplantation with reconstruction of the pulmonary artery (PA). We present two patients who underwent successful transplantation for PAH with giant PAA. One patient had end stage PAH and right pulmonary artery atresia complicated by a giant main PAA. This patient underwent bilateral sequential lung transplantation with concurrent pulmonary artery reconstruction. Another patient had end stage PAH with giant PAA on a background of D-transposition of the great arteries who had a Mustard repair at 9 months of age. This patient underwent heart-lung transplantation. Both heart-lung transplantation and lung transplantation with reconstruction of the pulmonary should be considered as a treatment option for patients with PAH with PAA.

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Section: Discussionmentioning

confidence: 98%

Surgical Management of Giant Pulmonary Artery Aneurysm in Patients with Severe Pulmonary Arterial Hypertension

Gajera

Doi

Niewodowski

et al. 2021

Preprint

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“…Bilateral lung transplant can be done in most pulmonary hypertension patients, even those with severe right ventricular dysfunction. Whilst bilateral lung transplantation has been utilised in the presence of PAA [18], the reason for considering heart and lung transplant in this scenario was due to the giant PAA size, severe pulmonary regurgitation due to annular dilatation and 4 cm pericardial effusion. The limitation of this approach is the increasing demand and short supply of suitable donor organs.…”

Section: Discussionmentioning

confidence: 99%

Heart-lung transplantation for idiopathic pulmonary arterial hypertension and giant pulmonary artery aneurysm – case report

Eadington

Santhanakrishnan

Venkateswaran

2020

J Cardiothorac Surg

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Backgound: Idiopathic pulmonary arterial hypertension (IPAH) is a rare condition that requires lung transplantation in patients' refractory to medical therapy. Pulmonary artery aneurysm (PAA) is a documented complication of IPAH however, optimal management and timing of intervention for this rare entity is not well understood. Case report: We report a case of a 51-year-old female who underwent heart-lung transplantation for IPAH and giant PAA. The extreme size of the PAA and underlying pathology encountered in this case precluded both lung transplantation and conventional aneurysm repair. Conclusion: This case demonstrates that heart-lung transplantation is a good surgical option for IPAH complicated by giant sized PAA and right heart failure.

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“…Our case presented indeed a giant aneurysm of the pulmonary artery (8.8 cm) and was further complicated, as rarely reported in such conditions, 6 by a massive pulmonary valve regurgitation and right ventricle dysfunction. HLT has been usually considered, in such a scenario, one option 2,4,7 and our patient was actually first listed for it. Unfortunately, the extreme rarity of an HL block availability and the clinical deterioration of the patient forced us to explore different options based on DLT.…”

Section: Discussionmentioning

confidence: 99%

Is it time for a paradigm shift: Should double‐lung transplant be considered the treatment of choice for idiopathic pulmonary arterial hypertension and giant pulmonary aneurysm?

Pelenghi

Primiceri

Belliato

et al. 2021

Journal of Cardiac Surgery

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Idiopathic pulmonary arterial hypertension is a rare condition, frequently complicated by pulmonary arteries’ aneurysm. Aggressive medical therapy is often unsatisfactory and lung transplantation remains the only option. We report a unique case of severe idiopathic pulmonary arterial hypertension complicated by a giant pulmonary aneurism, massive pulmonary valve regurgitation, and right ventricle dysfunction. The patient was, as our first choice, listed for heart–lung transplantation and remained in emergency list for more than 7 months. Unfortunately, due to further clinical deterioration and the unavailability of a heart–lung bloc, plan B was mandatory. The patient underwent a combined procedure including: double lung transplant, pulmonary artery plasty, and sutureless pulmonary valve prosthesis with open deployment (first‐in‐man use in such scenario). Postoperative outcome was uneventful. Our thought is that double lung transplantation and conventional combined pulmonary artery/valve surgery should be considered as the first option avoiding excessive waiting times and potential further clinical deterioration.

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Lung transplantation for pulmonary hypertension with giant pulmonary artery aneurysm

Cited by 18 publications

References 26 publications

Surgical Management of Giant Pulmonary Artery Aneurysm in Patients with Severe Pulmonary Arterial Hypertension

Surgical Management of Giant Pulmonary Artery Aneurysm in Patients with Severe Pulmonary Arterial Hypertension

Heart-lung transplantation for idiopathic pulmonary arterial hypertension and giant pulmonary artery aneurysm – case report

Is it time for a paradigm shift: Should double‐lung transplant be considered the treatment of choice for idiopathic pulmonary arterial hypertension and giant pulmonary aneurysm?

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