Impact of Left Ventricular Diastolic Dysfunction on Lung Transplantation Outcome in Patients With Pulmonary Arterial Hypertension

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
A AvrielJ Granton

Abstract

Diastolic dysfunction may influence perioperative outcome, early graft function, and long-term survival. We compared the outcomes of double lung transplantation (DLTx) for patients with pulmonary arterial hypertension (PAH) with preoperative left ventricular (LV) diastolic dysfunction with the outcomes of patients without diastolic dysfunction. Of 116 consecutive patients with PAH (who underwent transplantation between January 1995 and December 2013), 44 met our inclusion and exclusion criteria. Fourteen (31.8%) patients with diastolic dysfunction pretransplantation had a higher body mass index (29 [IQR 21.5-32.6] vs 22.4 [IQR 19.9-25.3] kg/m2 ) and mean pulmonary arterial pressure (54.6 ± 10 mmHg vs 47 ± 11.3 mmHg) and right atrial pressure (16.5 ± 5.2 mmHg vs 10.6 ± 5.2 mmHg). The patients received extracorporeal life support more frequently (33% vs 7% [p = 0.02]), had worse APACHE II scores (21.7 ± 7.4 vs 15.3 ± 5.3 [p = 0.02]), and a trend toward worse ventilator-free days (2.5 [IQR 6.5-32.5] vs 17 [IQR 3-23] [p = 0.08]). There was no effect on development of primary graft dysfunction or intensive care unit/hospital survival. One-year survival was worse (hazard ratio [HR] 4.45, 95% confidence interval [CI] 1.3-22, p = 0.02)...Continue Reading

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Dec 14, 2018·The European Respiratory Journal·Marius M HoeperWalter Klepetko
Jan 10, 2018·Seminars in Cardiothoracic and Vascular Anesthesia·J Mauricio Del RioKathirvel Subramaniam
Dec 4, 2019·Current Opinion in Anaesthesiology·Jeongae Yoon, Yuliana Salamanca-Padilla
Jan 4, 2022·General Thoracic and Cardiovascular Surgery·Akihiro OhsumiHiroshi Date

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