Document Detail

Pulmonary venous obstruction after lung transplantation. Diagnostic advantages of transesophageal echocardiography.
MedLine Citation:
PMID:  19732099     Owner:  NLM     Status:  MEDLINE    
Pulmonary venous vascular complications after lung transplantation are rare and a major cause of morbidity and mortality unless diagnosed and treated early. The epidemiological, diagnostic, and management characteristics of 33 patients (two of them in our hospital) with post-transplant pulmonary vein obstruction published in the literature were reviewed. We consider of utmost importance to differentiate stenosis from thrombosis as the cause of the obstruction. The angiography, considered the gold standard for diagnosis, was replaced by transesophageal echocardiography (TEE) in 79% of the cases, but no echocardiographic diagnostic criteria were defined. A diameter of the pulmonary veins, with 2D/color TEE, <0.5 cm, peak systolic flow velocity (PSFV) >1 m/s, pulmonary vein-left atrial pressure gradient (PVLAG) >/=10-12 mmHg, non-permeable flow through the stenosis and the presence of thrombus at that level, must lead us to suspect this complication. Higher mortality rates were found in unilateral procedures and in women. We consider that TEE must be carried out as part of the intraoperative routine or within the first 24 h of the post-operative period.
Camilo González-Fernández; Alejandro González-Castro; Juan Carlos Rodríguez-Borregán; Marta López-Sánchez; Borja Suberviola; Juan Francisco Nistal; Rafael Martín-Durán
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-09-03
Journal Detail:
Title:  Clinical transplantation     Volume:  23     ISSN:  1399-0012     ISO Abbreviation:  Clin Transplant     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  975-80     Citation Subset:  IM    
Department of Intensive Care Medicine, Hospital Universitario Marques de Valdecilla, Santander, Spain.
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MeSH Terms
Diagnosis, Differential
Echocardiography, Transesophageal / methods*
Fatal Outcome
Follow-Up Studies
Lung Transplantation / adverse effects*
Middle Aged
Pulmonary Fibrosis / surgery*
Pulmonary Veno-Occlusive Disease / etiology,  ultrasonography*

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