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Left Ventricular Unloading in a Patient with End‐stage Cardiomyopathy and Medically Unresponsive Pulmonary Hypertension
Author(s) -
AlKhaldi Abdulaziz,
Ergina Patrick,
DeVarennes Benoit,
Lachappelle Kevin,
Cecere Renzo
Publication year - 2004
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.2004.47332.x
Subject(s) - medicine , contraindication , cardiology , pulmonary hypertension , heart transplantation , heart failure , cardiomyopathy , ventricular assist device , ischemic cardiomyopathy , transplantation , vascular resistance , blood pressure , ejection fraction , alternative medicine , pathology
Severe, medically unresponsive pulmonary hypertension (PHT) is considered to be a contraindication for orthotopic heart transplantation (OHT). Chronic left ventricular (LV) unloading using a left ventricular assist device (LVAD) might result in reversal of the elevated pulmonary vascular resistance (PVR), allowing successful OHT in such patients. In this study, we present a patient with end‐stage ischemic cardiomyopathy and fixed, elevated PVR (7.1 Wood units) who underwent implantation of a Novacor LVAD (Baxter Healthcare Corp., Deerfield, IL, U.S.A.), with a subsequent reduction in PVR to 1.2 Wood units and successful OHT eleven months post‐LVAD implantation. Three years after heart transplant, the patient still leads an active life with no right heart failure. In conclusion, OHT is not contraindicated in patients with end‐stage heart failure and medically unresponsive PHT in the presence of elevated left atrial pressure. Left ventricular unloading should be considered in these patients to allow reversal of the elevated PVR before OHT.