Document Detail


Hemodynamic evaluation of heterotopic heart transplantation.
MedLine Citation:
PMID:  1495286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess the relative contribution of native and donor hearts to total circulatory performance after heterotopic transplantation, we used cardiac catheterization to examine 10 patients. Left and right ventricular filling pressures significantly decreased by 41% and 36%, respectively, cardiac index increased by 25%, and pulmonary arteriolar resistance was reduced by 61%. Patients were subdivided into two groups according to the presence of one (group I) or two (group II) peaks on the aortic pressure curve. In group I, the donor left ventricle assumed total left ventricular work and 80% of right ventricular work. Because the native left ventricle could not generate enough pressure to open the aortic valve, its entire stroke volume was ejected into the common left atrium. In addition, in all four patients a native aortic regurgitation occurred in diastole and systole. In contrast, in group II, native left ventricular systolic pressure always exceeded aortic diastolic pressure. The donor left ventricle contributed 68% to systemic blood flow and the donor right ventricle 51% to pulmonary blood flow. Mild native aortic regurgitation was demonstrated in two patients only. Native left ventricular function deteriorated postoperatively in all patients (ejection fraction decreased from 0.22 +/- 0.09 to 0.14 +/- 0.08), but this deterioration was more marked in group I. Postoperative depression of native left ventricular function could not be ascribed to progression of coronary artery disease but was mainly due to reduced preload (competitive filling) and increased afterload. Thus in group I patients with more severe preoperative left ventricular dysfunction, the donor heart behaved like a total biventricular assist device. In contrast, in group II patients the donor heart acted like a partial biventricular assist device.
Authors:
M Rigaud; J P Bourdarias; E el Khoury; A Beauchet; F Labedan; J Bardet; I Gandjbakhch; C Cabrol
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  104     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-09-04     Completed Date:  1992-09-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  248-55     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Hôpital Ambroise Paré, Boulogne, France.
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MeSH Terms
Descriptor/Qualifier:
Heart Catheterization
Heart Transplantation / physiology*
Hemodynamics / physiology*
Humans
Male
Middle Aged
Myocardial Contraction / physiology
Pulmonary Circulation / physiology
Transplantation, Heterotopic / physiology*
Ventricular Function / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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