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Left ventricular assist device to avoid heart–lung transplant in an adolescent with dilated cardiomyopathy and severely elevated pulmonary vascular resistance
Author(s) -
Yilmaz Betul,
Zuckerman Warren A.,
Lee Teresa M.,
Beddows Kimberly D.,
Gilmore Lisa A.,
Singh Rakesh K.,
Richmond Marc E.,
Chen Jonathan M.,
Addonizio Linda J.
Publication year - 2013
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12096
Subject(s) - medicine , dilated cardiomyopathy , vascular resistance , cardiology , contraindication , heart transplantation , heart failure , transplantation , cardiomyopathy , pulmonary hypertension , ventricular assist device , lung , hemodynamics , alternative medicine , pathology
Orthotopic heart transplantation remains the definitive treatment of choice for patients with end‐stage heart failure; however, elevated PVRI is a reported risk factor for mortality after heart transplant and, when severely elevated, is considered an absolute contraindication. Use of a ventricular assist device has been proposed as one treatment for reducing pulmonary vascular resistance index in potential heart transplant candidates refractory to medical vasodilator therapies. We report on a teenage patient with dilated cardiomyopathy and severely elevated PVRI , unresponsive to pulmonary vasodilator therapy, who underwent left ventricular assist device implantation to safely allow for aggressive pulmonary vasodilator therapy and to decrease PVRI . The resulting dramatic improvement in PVRI in a relatively short period of time allowed for successful heart transplantation, avoiding the need for heart–lung transplant.