Selective lung or heart-lung transplantation for pulmonary hypertension associated with congenital cardiac anomalies

Lupinetti, Flavian M.; Boiling, Steven F.; Bove, Edward L.; Brunsting, Louis A.; Crowley, Dennis C.; Lynch, Joseph P.; Whyte, Richard I.; Deeb, G. Michael

doi:10.1016/0003-4975(94)90119-8

Cited by 32 publications

(7 citation statements)

References 13 publications

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“…Patients subjected to HLT are also at risk for accelerated graft coronary disease, although the incidence in the series from Stanford University was only 8% at 5 years following the transplant. 42 For all these reasons, many authors have pointed out that HLT should be reserved for special indications such as patients with Eisenmenger syndrome caused by complex congenital heart disease, 41,51,52 or children.…”

Section: Choice Of Transplant Operationmentioning

confidence: 99%

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Atrial Septostomy and Transplantation for Patients with Pulmonary Arterial Hypertension

Corris

2009

Semin Respir Crit Care Med

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The development of specific disease-targeted therapy for pulmonary arterial hypertension has offered a major advancement in the management of patients, and these medical treatments have been shown to improve both quality and quantity of life. Nevertheless, many patients deteriorate with time and will require consideration of other approaches. This article focuses on the roles of atrial septostomy and lung transplantation.

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Section: Choice Of Transplant Operationmentioning

confidence: 99%

“…The group from Ann Arbor compared the outcome of SLT and simultaneous intracardiac repair versus HLT for patients with pulmonary hypertension secondary to congenital cardiac anomalies. 51 One SLT recipient died periooperatively. Three of the four remaining patients surviving the first year died during the second year.…”

Section: Comparative Studiesmentioning

confidence: 99%

Atrial Septostomy and Transplantation for Patients with Pulmonary Arterial Hypertension

Corris

2009

Semin Respir Crit Care Med

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“…The 1‐year survival rate for adults undergoing lung transplantation with primary intracardiac repair is 70–80% with less than 50% of patients alive 4 years after transplantation. The outcome after heart–lung transplantation is no better, 7–9 hence, every effort should be made to delay transplantation and palliative interventions play a significant role in their management.…”

Section: Discussionmentioning

confidence: 99%

A Novel Use of Atrial Septostomy and Stent Implantation in a Patient with Complex Cyanotic Congenital Heart Disease and Severe Pulmonary Hypertension

Chakrabarti¹,

Em²,

Salmon³

et al. 2004

J Interven Cardiology

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Patients with unpalliated complex cyanotic congenital heart may have significant morbidity resulting from severe pulmonary hypertension. In late stages, medical management is often difficult, and worsening right heart failure is resistant to medication. The risk of complications and early death can be averted by detailed evaluation and prompt intervention to identify the reversible elements that compound their physiology. It is vital to address any treatable issue to improve a patient's quality of life while awaiting heart-lung transplantation. Our case is a good example of such an approach, where the identification and treatment of reversible pulmonary venous hypertension in the background of irreversible pulmonary arterial hypertension, by offloading the left atrium by atrial septostomy and stent implantation, resulted in significant improvement in the quality of life for the patient.

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“…There are no specific guidelines that indicate the optimal time point for transplantation. If a patient is transplanted too early, it has to be realised that long-term survival rate for adults undergoing single or bilateral lung transplantation is < 50% after 4 years [28,111,112]. In addition, the 10-year survival rate after heart-lung transplantation is < 30 % [28]; however, if physical deterioration occurs rapidly, the decision for transplantation may come too late.…”

Section: Transplantationmentioning

confidence: 99%

Eisenmenger syndrome: medical prevention and management strategies

Budts¹

2005

Expert Opinion on Pharmacotherapy

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The original definition of Eisenmenger syndrome refers to an unrestrictive post-tricuspid valve congenital systemic-to-pulmonary shunt. When the pulmonary arterial systolic pressure becomes equal to the systemic arterial systolic pressure, the direction of the shunt becomes pulmonary-to-systemic. The latter leads to progressive cyanosis, and exercise intolerance is initially proportional to the degree of hypoxaemia. Later, congestive heart failure may occur . The management principle is to avoid any factors that destabilise this delicately balanced physiology. Until recently, this could only be achieved by symptomatic therapy; however, when patients are severely incapacitated, transplantation is needed. At present, new drugs, which are more selective pulmonary vasodilators, are available to interfere with the ongoing disease process to improve functional capacity and delay the decision for transplantation.

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Selective lung or heart-lung transplantation for pulmonary hypertension associated with congenital cardiac anomalies

Cited by 32 publications

References 13 publications

Atrial Septostomy and Transplantation for Patients with Pulmonary Arterial Hypertension

Atrial Septostomy and Transplantation for Patients with Pulmonary Arterial Hypertension

A Novel Use of Atrial Septostomy and Stent Implantation in a Patient with Complex Cyanotic Congenital Heart Disease and Severe Pulmonary Hypertension

Eisenmenger syndrome: medical prevention and management strategies

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