AI Article Synopsis
- Right-sided heart failure in donor hearts after transplantation is mainly due to high pulmonary artery pressure and resistance, impacting perioperative mortality rates.
- After a transplant, pulmonary hypertension usually improves and normalizes within a month, but this case highlights ongoing hypertension after heterotopic heart transplantation due to initially high pulmonary artery resistance.
- Despite persistent elevated pressures and resistance noted over 6 months of follow-up, the patient remains asymptomatic and in good clinical condition, prompting a discussion on the pros and cons of heterotopic heart transplantation.
Article Abstract
Right-sided failure occurring in the donor heart immediately after transplantation is primarily caused by increased recipient pulmonary artery pressure and resistance and represents one of the leading causes of perioperative mortality associated with orthotopic heart transplantation. After transplantation pulmonary hypertension gradually declines, returning to near normal levels within 30 days of transplantation. This article describes a case report of the persistence of pulmonary hypertension after heterotopic heart transplantation. The heterotopic position was utilized because of marked elevation of the pulmonary artery resistance (18 Wood units) calculated at the time of operation. Cardiac catheterization data-obtained during the subsequent 6 months of follow-up showed persistent elevation of pulmonary artery pressure and pulmonary vascular resistance. The patient, however, clinically continues to feel well and remains asymptomatic without signs of right-sided heart failure. Indications, suggested advantages, and demonstrated disadvantages of heterotopic heart transplantation are discussed.
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