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Right arrow Transplantation - heart

Ann Thorac Surg 2002;74:584-586
© 2002 The Society of Thoracic Surgeons

Case report

Echocardiographic evidence of right ventricular remodeling after transplantation

Holger K. Eltzschig, MDa, Tomislav Mihaljevic, MDb, John G. Byrne, MDb, Raila Ehlers, MDc, Brian Smith, RDCSa, Stanton K. Shernan, MD*a

a Department of Anesthesiology, Perioperative and Pain Medicine, Boston, Massachusetts, USA
b Division of Cardiac Surgery, Boston, Massachusetts, USA
c Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

Accepted for publication February 27, 2002.

* Address reprint requests to Dr Shernan, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115 USA
e-mail: shernan{at}zeus.bwh.harvard.edu

Right ventricular (RV) failure is a significant source of mortality after cardiac transplantation. The use of RV assist devices (RVAD) as a bridge to recovery has been reported. However, early changes of RV structure and anatomy after RVAD implantation have yet to be described. We report a case of RV failure after transplantation requiring RVAD implantation. After 3 weeks of gradual weaning of inotropic and RVAD support, the device was explanted successfully. Transesophageal echocardiography documents RV hypertrophy and remodeling between RVAD implantation and removal, suggesting a rapid adaptive response of the right ventricle in the presence of pulmonary hypertension.




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