Chen Jing-yu, Zhang Qing-guang, Jing Zhao-hui, He Yi-jun, Zheng Ming-feng, Zhu Yan-hong, Hu Chun-xiao
Group of Lung Transplant, Wuxi Chest Hospital, Wuxi 214073, China.
Zhonghua Yi Xue Za Zhi. 2007 May 8;87(17):1165-8.
To discuss the operative indications and peri-operational management of single lung transplantation (SLT) and heart-lung transplantation (HLT) for patients suffering from Eisenmenger's syndrome (ES).
From September.2002 to March.2006, four ES patients, 1 males and 3 females, aged 16 approximately 19, 2 with atrial septal defect and 2 with ventricular septal defect, underwent single right lung transplantation, and one patients, male, aged 43, who suffered heart failure secondary to an interventional occlusion for atrial septal defect underwent cardiac repair and HLT.
Two patients, including the patient who received HLT and one, female, aged 15, who received SHT died of he died primary graft dysfunction on the 23rd day and 20th day post-operationally respectively. While the other 3 recipients kept a normal life for 5, 8, and 22 months respectively after operation with apparently decreased pulmonary artery pressure and improved cardiac-pulmonary functions.
Lung transplantation companies with cardiac repair is effective in the therapy of ES. Donor-recipient matching in size, proper removal and protection of the donor lung, and appropriate postoperational management are the key procedures for those patients to survive.
探讨艾森曼格综合征(ES)患者单肺移植(SLT)和心肺移植(HLT)的手术适应证及围手术期管理。
2002年9月至2006年3月,4例ES患者,男1例,女3例,年龄16至19岁,2例为房间隔缺损,2例为室间隔缺损,接受了右单肺移植;1例43岁男性患者,因房间隔缺损介入封堵后继发心力衰竭,接受了心脏修复和HLT。
2例患者,包括接受HLT的患者和1例15岁接受SHT的女性患者,分别于术后第23天和第20天死于原发性移植肺功能障碍。而其他3例受者术后分别正常生活了5个月、8个月和22个月,肺动脉压明显下降,心肺功能改善。
心肺联合移植治疗ES有效。供受者大小匹配、供肺的妥善摘取和保护以及适当的术后管理是这些患者存活的关键步骤。