Original clinical scienceImpact of fixed pulmonary hypertension on post–heart transplant outcomes in bridge-to-transplant patients
Section snippets
Patient population
This is a retrospective cohort study that included 54 patients undergoing VAD implantation as a bridge to transplantation from 1999 to 2008 at two institutions (Rigshospitalet, Denmark, and the Toronto General Hospital, Canada). The devices utilized were the HeartMate XVE, the HeartMate II (Thoratec Corp., Pleasanton, CA) and the Novacor (World Heart Corp., Oakland, CA). Patients were divided in two groups according to the presence or absence of FPH prior to VAD implantation. Twenty-two (41%)
Baseline characteristics
A total of 54 patients were included in this study. The median overall age was 44.5 years (range 17 to 63 years) and 90% (46 patients) were male. The median follow-up was 2.8 years. Pulmonary hypertension was present in 41% (22 patients) of the population. Baseline characteristics (Table 1) were similar among patients with and without FPH, except that patients in the FPH group were older (46 ± 11 years vs 39 ± 13 years in NoFPH group, p < 0.05) and showed a trend toward higher incidence of
Discussion
This study has shown that VAD therapy decreases FPH in advanced heart failure patients, allowing them to safely undergo heart transplantation. In addition, among heart transplant candidates supported with a VAD, long-term post-transplant survival in patients with FPH is comparable to that of patients without FPH.
Pulmonary hypertension is a common complication of severe chronic heart failure that may preclude cardiac transplantation. Moderate to severe FPH (>2.5 Wood units) is present in
Disclosure statement
The authors have no conflicts of interests to disclose.
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