Objective: Fixed pulmonary hypertension is a contraindication for cardiac transplantation because of the increased risk of donor heart failure. We sought to determine whether left ventricular assist devices improve fixed pulmonary hypertension in cardiac transplant candidates to enable safe cardiac transplantation.
Methods: Thirty-five consecutive cardiac transplant candidates (age 56 +/- 6 years, 88.5% were men) with fixed pulmonary hypertension (5.1 +/- 2.6 Wood units) resistant to medical treatment received a left ventricular assist device as a bridge to transplantation. Three left ventricular assist device systems were used (pulsatile blood flow: Novacor [World Heart Inc, Oakland, Calif] n = 8; continuous blood flow: MicroMed DeBakey [MicroMed Technology Inc, Houston, Tex] n = 24, DuraHeart [Terumo Heart Inc, Ann Arbor, Mich] n = 3). Right-sided heart catheter data were obtained before left ventricular assist device implantation at 3-day and 6-week follow-ups. Clinical data and complications were recorded.
Results: Before left ventricular assist device implantation, the pulmonary vascular resistance was 5.1 +/- 2.8 Wood units. Values were comparable in patients receiving pulsatile (5.1 +/- 3.4 Wood units) or continuous blood flow left ventricular assist devices (5.1 +/- 2.7 Wood units, P = .976). Left ventricular assist device implantation decreased pulmonary vascular resistance at 3-day (2.9 +/- 1.3 Wood units, P < .0001) and 6-week (2.0 +/- 0.8 Wood units, P < .0001) follow-ups compared with before implantation. This effect was independent of the type of left ventricular assist device system used (3-day follow-up: pulsatile flow: 3.2 +/- 1.3 Wood units vs continuous flow: 2.7 +/- 1.2 Wood units; P = .310 and 6-week follow-up: pulsatile flow: 1.9 +/- 0.9 Wood units vs continuous flow: 2.1 +/- 0.8 Wood units; P = .905). Twenty-four patients had successful bridges to transplantation (69%, mean time on left ventricular assist device 210 +/- 83 days), and 11 patients died before transplantation (31%, mean time on left ventricular assist device 67 +/- 30 days). The 1-year survival after transplantation was 95%.
Conclusion: Left ventricular assist devices decrease fixed pulmonary hypertension in cardiac transplant candidates and allow patients to overcome a contraindication for cardiac transplantation. Therefore, left ventricular assist devices should be considered in all cardiac transplant candidates with fixed pulmonary hypertension.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jtcvs.2006.08.104 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The implication of pericardial effusion in the third trimester for preeclampsia and heart failure in high-risk pregnant women.
J Echocardiogr
January 2025
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, 1035 Dalgubeol-Daero, Dalseo-Gu, Daegu, 42601, Republic of Korea.
Background: With the growing number of high-risk pregnant women, echocardiography frequently reveals pericardial effusion (PE). However, the clinical implications of PE are unknown.
Method: We analyzed a cohort of 406 high-risk pregnant women who underwent echocardiography in the third trimester between November 2019 and December 2022.
Clarifying the Cardiovascular Morphology and Associated Abnormalities in Patients with Double Inlet Right Ventricle Using Multidetector CT Angiography.
Pediatr Cardiol
January 2025
Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India.
We sought to evaluate the intracardiac morphology and associated cardiovascular anomalies in patients with double inlet right ventricle (DIRV) on multidetector CT angiography. A retrospective search of our departmental database was conducted from January 2014 to January 2023 to identify patients with a diagnosis of DIRV on CT angiography. The intracardiac anatomy and associated cardiovascular abnormalities were systematically evaluated.
View Article and Find Full Text PDFEffects of genetic mutations on left ventricular myocardial mechanics and fibrosis patterns in hypertrophic cardiomyopathy.
Sci Rep
January 2025
Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Myocyte disarray and fibrosis are underlying pathologies of hypertrophic cardiomyopathy (HCM) caused by genetic mutations. However, the extent of their contributions has not been extensively evaluated. In this study, we investigated the effects of genetic mutations on myofiber function and fibrosis patterns in HCM.
View Article and Find Full Text PDFCardiorespiratory fitness, cardiac morphology and function, and cardiovascular risk factors in long-term breast cancer survivors compared with non-cancer controls.
Cardiooncology
January 2025
ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Oslo, Norway.
Background: Although anthracycline-related cardiotoxicity is widely studied, only a limited number of echocardiographic studies have assessed cardiac function in breast cancer survivors (BCSs) beyond ten years from anthracycline treatment, and the knowledge of long-term cardiorespiratory fitness (CRF) in this population is scarce. This study aimed to compare CRF assessed as peak oxygen uptake (V̇O), cardiac morphology and function, and cardiovascular (CV) risk factors between long-term BCSs treated with anthracyclines and controls with no history of cancer.
Methods: The CAUSE (Cardiovascular Survivors Exercise) trial included 140 BCSs recruited through the Cancer Registry of Norway, who were diagnosed with breast cancer stage II to III between 2008 and 2012 and had received treatment with epirubicin, and 69 similarly aged activity level-matched controls.
The expression of MALAT1, plasma brain natriuretic peptide, and Tei index in sepsis-induced myocardial injury.
J Cardiothorac Surg
January 2025
Emergency and Critical Care Center, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
Purpose: We sought to investigate the expression of MALAT1, plasma brain natriuretic peptide, and Tei index in sepsis-induced myocardial injury.
Methods: The current retrospective analysis focused on 146 sepsis patients admitted to our hospital from February 2021 to March 2023. Based on the presence or absence of myocardial injury, the patients were divided into two groups: the sepsis group (n = 80) and the sepsis-induced myocardial injury group (n = 66).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!