Article: article from journal or magazin.
Case report (case report): feedback on an observation with a short commentary.
Severe left ventricular dysfunction secondary to primary pulmonary hypertension: bridging therapy with bosentan before lung transplantation.
Journal of Heart and Lung Transplantation
Publication types: Case Reports ; Journal Article
When right ventricular failure develops secondary to primary pulmonary hypertension, right-left ventricular interaction may lead to severe impairment of left ventricular function. In such cases, many experts favor combined heart-lung transplantation by fear that the left ventricle may not recover after transplantation of the lungs alone. We report a case of primary pulmonary hypertension with severely diminished right and left ventricular function. The patient was rendered amenable to isolated pulmonary transplantation with the endothelin-receptor antagonist bosentan. The medication improved right and left ventricular function to the point that heart transplantation no longer appeared necessary. After double-lung transplantation the patient's cardiac function made a full recovery. This approach might be particularly welcome considering both the current donor organ shortage and the limited number of surgical teams with expertise in heart-lung transplantation.
Adult, Antihypertensive Agents/therapeutic use, Combined Modality Therapy, Humans, Hypertension, Pulmonary/complications, Hypertension, Pulmonary/therapy, Lung Transplantation, Male, Severity of Illness Index, Sulfonamides/therapeutic use, Ventricular Dysfunction, Left/etiology, Ventricular Dysfunction, Right/etiology
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