Severe ventricular dysfunction and concomitant infection are considered absolute contraindications for major thoracic operations and immunosuppressive therapy, respectively. However, cardiac transplantation represents the first-choice treatment in advanced heart failure. We report the case of a patient with dilated cardiomyopathy and severe left ventricular dysfunction (ejection fraction = 25%), initially not considered as a potential heart transplant candidate due to the presence of a lung abscess. The patient subsequently underwent atypical pulmonary resection with intraoperative and perioperative intraaortic balloon counter-pulsation for circulatory support and was then listed for cardiac transplant. Pitfalls and intra/postoperative strategy, all of which are potentially important aspects in minimizing operative risk, are discussed.

Chirurgia polmonare ad alto rischio in potenziali candidati a trapianto cardiaco=High-risk pulmonary surgery in potential candidates for a heart transplant / F. Donatelli, M. Pocar, G. Marchetto, A. Moneta, E. Villa, A. Grossi. - In: GIORNALE ITALIANO DI CARDIOLOGIA. - ISSN 0046-5968. - 29:11(1999 Nov), pp. 1331-1333.

Chirurgia polmonare ad alto rischio in potenziali candidati a trapianto cardiaco=High-risk pulmonary surgery in potential candidates for a heart transplant

F. Donatelli
Primo
;
M. Pocar
Secondo
;
G. Marchetto;E. Villa
Penultimo
;
A. Grossi
Ultimo
1999-11

Abstract

Severe ventricular dysfunction and concomitant infection are considered absolute contraindications for major thoracic operations and immunosuppressive therapy, respectively. However, cardiac transplantation represents the first-choice treatment in advanced heart failure. We report the case of a patient with dilated cardiomyopathy and severe left ventricular dysfunction (ejection fraction = 25%), initially not considered as a potential heart transplant candidate due to the presence of a lung abscess. The patient subsequently underwent atypical pulmonary resection with intraoperative and perioperative intraaortic balloon counter-pulsation for circulatory support and was then listed for cardiac transplant. Pitfalls and intra/postoperative strategy, all of which are potentially important aspects in minimizing operative risk, are discussed.
Cardiomyopathy; Heart failure; Heart transplantation
Settore MED/23 - Chirurgia Cardiaca
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
Settore MED/21 - Chirurgia Toracica
Settore MED/10 - Malattie dell'Apparato Respiratorio
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/202919
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