Effect of pulmonary vascular resistance before left ventricular assist device implantation on short- and long-term post-transplant survival

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Abstract

Objectives Pulmonary hypertension is often considered a contraindication to orthotopic heart transplantation. Left ventricular assist device support may improve pulmonary hypertension by unloading the left ventricle, making patients eligible for transplantation. We sought to investigate the effect of continuous-flow left ventricular assist device support on pulmonary hypertension and compare post-transplantation outcomes in patients with preexisting pulmonary hypertension. Methods Between March 2004 and December 2013, 256 potential orthotopic heart transplantation candidates underwent continuous-flow left ventricular assist device implantation at Columbia University. Preimplantation right heart catheterization data were available for 227 patients. Patients were divided into 2 groups on the basis of preimplantation pulmonary vascular resistance: low (<5 Wood units) (n = 182) and high (≥5 Wood units) (n = 45). Postimplantation and post-transplantation outcomes were compared between the groups. Results Pulmonary vascular resistance in the high resistance group decreased significantly during left ventricular assist device support (P

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Tsukashita, M., Takayama, H., Takeda, K., Han, J., Colombo, P. C., Yuzefpolskaya, M., … Naka, Y. (2015). Effect of pulmonary vascular resistance before left ventricular assist device implantation on short- and long-term post-transplant survival. Journal of Thoracic and Cardiovascular Surgery, 150(5), 1352-1361.e2. https://doi.org/10.1016/j.jtcvs.2015.07.012

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