The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
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J. Heart Lung Transplant. · May 1995
Comparative StudyVasodilator therapy after heart transplantation: effects of inhaled nitric oxide and intravenous prostacyclin, prostaglandin E1, and sodium nitroprusside.
Vasodilator therapy is frequently needed to treat pulmonary hypertension after heart transplantation. In the present study, the effects of intravenous sodium nitroprusside, prostacyclin, prostaglandin E1, and inhaled nitric oxide (5, 10, and 20 parts per million) on central hemodynamics, right ventricular function, and pulmonary selectivity were evaluated shortly after heart transplantation. ⋯ Prostacyclin is the best choice for intravenous vasodilator therapy after heart transplantation. However, inhaled nitric oxide is the only selective pulmonary vasodilator, which should be used in cases of pulmonary hypertension and severe right ventricular failure associated with systemic hypotension.
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J. Heart Lung Transplant. · May 1995
Case ReportsDiagnosis of patent foramen ovale with transesophageal echocardiography in a patient supported with a left ventricular assist device.
Intracardiac right-to-left shunting through a patent foramen ovale is a known cause of arterial hypoxemia. We present a case report of a patient supported with a left ventricular assist device who had significant right-to-left shunting as visualized with transesophageal echocardiography. When the device was turned off, no further shunting occurred and arterial hypoxemia resolved. Our report is the first visual representation of the anatomy of a patent foramen ovale in a patient supported with a left ventricular assist device.
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J. Heart Lung Transplant. · Mar 1995
Comparative StudyDoes the mode of donor death influence the early outcome of lung transplantation? A review of lung transplantation from donors involved in major trauma.
Pulmonary dysfunction, often delayed in presentation, is among the sequelae of major trauma. Transplantation of lungs from donors involved in major trauma therefore carries a risk of early graft dysfunction. This study was conducted to assess this risk. ⋯ The use of donors involved in major trauma does not increase the risk of early complications after lung transplantation providing their specific characteristics are recognized.
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J. Heart Lung Transplant. · Mar 1995
Comparative StudyAssessment of forced expiratory volume in one second-fraction of the engrafted lung with 133-Xe radiospirometry improves the diagnosis of bronchiolitis obliterans syndrome in single lung transplant recipients.
Staging of bronchiolitis obliterans syndrome is based on the decline of forced expiratory volume in 1 second, a measure of overall ventilatory capacity. A single staging system is applied to all lung recipients, regardless of the bias which can be caused by the native lung after single lung transplantation. ⋯ The assessment of forced expiratory volume in 1 second seems to underestimate the severity of chronic dysfunction in single lung grafts. Instead, the determination of forced expiratory volume in 1 second of the transplant with radioactive tracers provides selective information of the graft function, which could be used for clinical evaluation of bronchiolitis obliterans syndrome in single lung recipients.
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J. Heart Lung Transplant. · Jan 1995
Reduced work of breathing after single lung transplantation for emphysema.
Pulmonary emphysema, with or without chronic bronchitis, has emerged as the most common indication for successful single lung transplantation. Although gas exchange can be expected to improve after successful transplantation, such changes do not adequately explain the improvement in dyspnea experienced by these patients and resulting in improved quality of life. ⋯ The decline in lung compliance after single lung transplantation reflects the importance of improvement in elastic recoil and reduced chest wall distention, improving the work of breathing. The 67% decline in static lung compliance (300% increase in elastic recoil) is probably the single most important mechanical factor leading to reduced dyspnea after single lung transplantation for emphysema.