Shumway S J, Baughman K L, Traill T A, Cameron D E, Fonger J D, Gardner T J, Achuff S C, Reitz B A, Baumgartner W A
Johns Hopkins Medical Institutions, Baltimore, Maryland.
J Heart Transplant. 1989 Sep-Oct;8(5):387-90.
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.
移植后立即在供体心脏出现的右侧心力衰竭主要由受体肺动脉压力和阻力增加引起，是原位心脏移植围手术期死亡的主要原因之一。移植后肺动脉高压逐渐下降，在移植后30天内恢复到接近正常水平。本文描述了一例异位心脏移植后肺动脉高压持续存在的病例报告。由于手术时计算出的肺动脉阻力显著升高（18伍德单位），采用了异位位置。在随后6个月的随访期间获得的心脏导管检查数据显示肺动脉压力和肺血管阻力持续升高。然而，该患者临床上仍感觉良好，无症状，无右侧心力衰竭迹象。本文讨论了异位心脏移植的适应症、潜在优势和已证实的劣势。
