Novel mechanism of mitral regurgitation after lung transplantation in a patient with scleroderma and pulmonary hypertension

Mitral Regurgitation After Orthotopic Lung Transplantation: Natural History and Impact on Outcomes

“…[1][2][3][4] In these reports, prolonged mechanical ventilation or oxygen dependency led to further investigation and unmasking of significant valvular pathology. Recognition of the progression of MR occurred within the first 3 months postoperatively, indicating a unique postoperative phenomenon.…”

“…Subsequently, other cases were reported that described new-onset MR that led to respiratory compromise, including a dramatic case of new-onset severe MR that was recognized only after the patient could not be weaned from mechanical ventilation for 42 days after OLT, with successful subsequent extubation on the fifth postoperative day after mitral valve repair. 1,3,4 One hypothesis attributes worsening of MR to a reduction in size of the right ventricle (RV), producing inverse changes in the left ventricle and mitral annulus. 1 According to this hypothesis, the primary lung disease causes pulmonary hypertension, which results in RV dilation and dysfunction.…”

“…1,3,4 One hypothesis attributes worsening of MR to a reduction in size of the right ventricle (RV), producing inverse changes in the left ventricle and mitral annulus. 1 According to this hypothesis, the primary lung disease causes pulmonary hypertension, which results in RV dilation and dysfunction. The RV dilation then results in a reduction of the size of the mitral valve (MV) annulus.…”

Pulmonary Dysfunction After Lung Transplantation: The Dilemma of Coexisting Mitral Regurgitation

“…In a case with a similar course, Bermudez et al described a patient with IPF who underwent BOLT. 2 Attempts to wean ventilatory support were unsuccessful. Six weeks postoperatively, a TTE showed previously unrecognized severe MR.…”

“…P ROGRESSION of mitral regurgitation (MR) after lung transplantation previously has been found in patients who were unable to be weaned from mechanical ventilation postoperatively, 1,2 In these patients, surgical repair of the mitral valve (MV) led to successful respiratory recovery. The authors report an unusual case of a patient who underwent left single orthotopic lung transplant (SOLT) and postoperative pulmonary compromise.…”