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Sequential hemodynamic evaluation in heart transplantation

heart transplantation has been widely employed in treatment of end stage cardiomyopathy. Great interest exists in the study of early and late hemodynamic alterations following the procedure. Fourty three patients submited to heart transplantation were studied with this aim. The data obtained were: cardiac index, pressure in the heart chambers, capillary wedge pressure, aorta and pulmonary artery pressure, systolic volume and ejection fraction of left ventricle, pulmonary and systemic vascular resistances; left and right work systolic indexes; triple product. The data were compared in groups with and without rejection and in groups with higher and lower transpulmonary gradients. It was observed that in the immediate period there was impairment of ventricle function due to several factors. The cardiac index is maintained in adequate levels through several mechanisms, adaptation of the ventricles occur earlier in the right than in the left ventricle; lately hemodynamic alterations depend on the appearance of systemic arterial hypertension and coronary atherosclerosis. The presence of rejection and higher values for transpulmonary gradient had no statistically significant influence in hemodynamic condition.

heart transplantation; heart transplantation


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