Heart–lung and lung transplantation in grown-up congenital heart disease: long-term single centre experience☆

Goerler, Heidi; Simon, Andrè; Gohrbandt, Bernhard; Hagl, Christian; Oppelt, P; Weidemann, Juergen; Haverich, Axel; Strueber, M.

doi:10.1016/j.ejcts.2007.08.024

Cited by 54 publications

(28 citation statements)

References 15 publications

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“…However, another study showed a highly significant benefit of heart-lung transplantation over lung transplantation for patients with a VSD [61]. This is also consistent with another single center experience [58]. …”

Section: Surgical Aspectssupporting

confidence: 83%

“…Previous operative procedures seem to have a negative impact on survival after transplantation and the existence of extensive pleuro-pulmonary collateral vessels are considered a contraindication for heart-lung transplantation [58]. …”

Section: Surgical Aspectsmentioning

confidence: 99%

“…Heart-lung transplantation can be a successful procedure for Eisenmenger patients with end-stage disease if the procedure is performed by an experienced team [58, 61, 62]. One, 5-year and 10-year survival ranges between 70% and 80%, 50% and 70%, 30% and 50%, respectively [58, 61, 62].…”

Section: Surgical Aspectsmentioning

confidence: 99%

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The Adult Patient with Eisenmenger Syndrome: A Medical Update after Dana Point Part III: Specific Management and Surgical Aspects

Oechslin

Mebus²,

Schulze‐Neick³

et al. 2010

CCR

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Eisenmenger syndrome is the most severe form of pulmonary arterial hypertension and arises on the basis of congenital heart disease with a systemic-to-pulmonary shunt. Due to the chronic slow progressive hypoxemia with central cyanosis, adult patients with the Eisenmenger syndrome suffer from a complex and multisystemic disorder including coagulation disorders (bleeding complications and paradoxical embolisms), renal dysfunction, hypertrophic osteoarthropathy, heart failure, reduced quality of life and premature death.For a long time, therapy has been limited to symptomatic options or lung or combined heart-lung transplantation. As new selective pulmonary vasodilators have become available and proven to be beneficial in various forms of pulmonary arterial hypertension, this targeted medical treatment has been expected to show promising effects with a delay of deterioration also in Eisenmenger patients. Unfortunately, data in Eisenmenger patients suffer from small patient numbers and a lack of randomized controlled studies.To optimize the quality of life and the outcome, referral of Eisenmenger patients to spezialized centers is required. In such centers, specific interdisciplinary management strategies of physicians specialized on congenital heart diseases and PAH should be warranted. This medical update emphasizes the current diagnostic and therapeutic options for Eisenmenger patients with particularly focussing on specific management and surgical aspects.

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Section: Surgical Aspectssupporting

confidence: 83%

Section: Surgical Aspectsmentioning

confidence: 99%

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The Adult Patient with Eisenmenger Syndrome: A Medical Update after Dana Point Part III: Specific Management and Surgical Aspects

Oechslin

Mebus²,

Schulze‐Neick³

et al. 2010

CCR

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show abstract

“…Heart and lung transplant recipients have a one-year survival of 60-80% and a ten-year survival less than 30%. 31,32 Pregnancy and Eisenmenger's syndrome Physiological changes of pregnancy impose an increased demand on the cardiovascular system. In patients with Eisenmenger's syndrome oxygenation deteriorates secondary to worsening of the right to left shunt.…”

Section: Management Of Eisenmenger's Syndromementioning

confidence: 99%

A functional understanding of moderate to complex congenital heart disease and the impact of pregnancy. Part II: Tetralogy of Fallot, Eisenmenger’s syndrome and the Fontan operation

Naguib

Dob

Gatzoulis

2010

International Journal of Obstetric Anesthesia

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“…1 Goerler et al also reported feasible risks and favorable outcome in patients with Eisenmenger syndrome who underwent HLT for end-stage congenital heart disease. 2 Trulock et al reported that recipients with Eisenmenger syndrome had a better survival rate than did patients with other congenital disorders or primary pulmonary hypertension in those who underwent HLT. 3 On the other hand, it has been reported that bilateral sequential lung transplantation for Eisenmenger syndrome is an alternative procedure with morbidity/mortality and survival comparable to HLT.…”

Section: Discussionmentioning

confidence: 99%

Bilateral lung transplantation with closure of ventricular septal defect in a patient with Eisenmenger syndrome

Inoue

Minami

Fukushima

et al. 2010

Gen Thorac Cardiovasc Surg

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We report the first case with Eisenmenger syndrome secondary to an isolated perimembranous ventricular septal defect (VSD) in a patient who underwent bilateral lung transplantation and closure of the VSD in Japan. This male patient was diagnosed as having a VSD associated with severe pulmonary hypertension at the age of 7, and right unilateral pulmonary artery banding was performed at age 9. At 38 years of age, we performed bilateral cadaveric lung transplantation with patch closure of the VSD. Explant pathology revealed grade 3 for the right lung and grade 4 for the left lung by the Heath-Edwards classification. The ventricular contractility had gradually improved, and ventricular arrhythmia requiring amiodarone prior to lung transplantation had disappeared. When cardiac function is preserved, bilateral lung transplantation is an option for patients with Eisenmenger syndrome secondary to VSD and should be considered as an alternative to heart-lung transplantation, especially in Japan, where donor organ shortage is critical.

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Heart–lung and lung transplantation in grown-up congenital heart disease: long-term single centre experience☆

Abstract: Lung and heart-lung transplantation can be performed with an acceptable risk and a favourable long-term outcome in patients with grown-up CHD. Careful patient selection and planning of the surgical strategy is essential in this high-risk patient population.

Cited by 54 publications

References 15 publications

The Adult Patient with Eisenmenger Syndrome: A Medical Update after Dana Point Part III: Specific Management and Surgical Aspects

The Adult Patient with Eisenmenger Syndrome: A Medical Update after Dana Point Part III: Specific Management and Surgical Aspects

A functional understanding of moderate to complex congenital heart disease and the impact of pregnancy. Part II: Tetralogy of Fallot, Eisenmenger’s syndrome and the Fontan operation

Bilateral lung transplantation with closure of ventricular septal defect in a patient with Eisenmenger syndrome

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