EARLY RIGHT VENTRICULAR failure after orthotopic heart transplantation is a common complication that has profound effects on patient survival and morbidity.
1It is believed that the vast majority of cases of early post-transplant right ventricular dysfunction are the result of ischemia-reperfusion injury secondary to warm ischemic time, ineffective cardioplegia, coronary air embolism, and/or mechanical trauma at harvest.
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- Bennett L.E.
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The registry of the international society for heart and lung transplantation: Fifteenth official report.
J Heart Lung Transplantation. 1998; 17: 656-668
2In addition, unlike the left ventricle, the right ventricle does not tolerate acute increases in afterload, placing patients with elevated pulmonary vascular resistance at risk for post-transplant right-heart failure.
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Severe right heart failure after heart transplantation A single-center experience.
Transplant Int. 2005; 18: 326-332
3Rarely, mechanical causes of post-transplant right ventricular dysfunction can be identified. A case of early post-transplant right ventricular failure secondary to iatrogenic cor triatriatum is presented. The transesophageal echocardiographic (TEE) and hemodynamic abnormalities associated with this rare complication are reviewed.
- Chen E.P.
- Bittner H.B.
- Davis R.D.
- et al.
Right ventricular adaptation to increased afterload after orthotopic cardiac transplantation in the setting of recipient chronic pulmonary hypertension.
Circulation. 1997; 96: II-141-II-147
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- Severe right heart failure after heart transplantation.Transplant Int. 2005; 18: 326-332
- Right ventricular adaptation to increased afterload after orthotopic cardiac transplantation in the setting of recipient chronic pulmonary hypertension.Circulation. 1997; 96: II-141-II-147
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Linda Shore-Lesserson, MD
Mark A. Chaney, MD
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.