2018, Number 4
Cir Card Mex 2018; 3 (4)
Trasplante cardiaco en hipertensión pulmonar limítrofe: reporte de un caso
Araiza-Navarro JR, García-Negrete E, Daner-Alis G
Full text
Language: Spanish
References: 6
Page: 131-133
PDF size: 179.86 Kb.
ABSTRACT
Cardiac transplantation is the surgical therapeutic option intended as a final therapy for patients with endstage heart failure, where other medical and/or surgical treatments have not been successful. We present herein the case of a 63 yerar-old male patient, diagnosed as heart failure in NYHA functional class IV, secondary to dilated cardiomyopathy, with left ventricular ejection fraction of 20%, systolic pulmonary artery pressure of 75 mmhg. Right cardiac catheterization was performed finding a systolic pulmonary pressure of 70 mmhg, transpulmonary gradient of 13 mmHg, and pulmonary vascular resistance of 6 Wood units. Pharmacological test was carried out with oral sildenafil 100 mg and inhaled nitric oxide at 10 ppm, achieving a reduction in systolic pulmonary artery pressure to 55 mmhg, a transpulmonary gradient to 9 mmHg, and pulmonary vascular resistance to 4 Wood units. Cardiac translpantation was performed, and immediate postoperative management with inhaled Nitric oxide, nebulized Iloprost, Sildenafil and Bosentán, all of them given all along for the first 15 days after operation. Systolic pulmonary artery pressure less than 35 mmHg, and no data of right ventricular failure were both obtained. Patient got discharged with left ventricular ejection fraction of 65%, systolic pulmonary artery pressure of 28 mmhg. Medical treatment with Sildenafil 100 mg 250 mg twice daily, and Bosentan 125 mg twice daily by oral administration is currently given to the patient. At present, he is in NYHA functional class I.REFERENCES