TY  - JOUR
AU  - Emerson, Dominic
AU  - Kobashigawa, Jon
AU  - Levine, Ryan
AU  - Moriguchi, Jamie
AU  - Megna, Dominick
AU  - Chung, Joshua
AU  - Ramzy, Dany
AU  - Trento, Alfredo
AU  - Esmailian, Fardad
PY  - 2020
DA  - 2020/07/06
TI  - Single-Center Outcomes of Heart Transplantation in Patients with Pulmonary Hypertension Bridged with Mechanical Circulatory Support
JO  - OBM Transplantation
SP  - 114
VL  - 04
IS  - 03
AB  - In advanced heart failure, orthotopic heart transplantation (OHT) remains the standard for definitive treatment. Patients with heart failure and concomitant pulmonary hypertension (PH) represent a challenging subgroup, with poor outcomes following OHT. Recently, Mechanical Circulatory Support (MCS) devices have been utilized as a bridge to OHT for these patients. Patients with MCS devices who underwent OHT were evaluated at a single center. Patients were stratified into three groups, depending on baseline pulmonary vascular resistance (PVR). Groups were analyzed for outcomes. One hundred twenty three patients were identified. Of these, 39 had a PVR ≤1.6, 50 had a PVR >1.6 and ≤ 3, and 34 had a PVR >3. Demographics were generally similar. Tricuspid valve regurgitation (TR) was significantly higher among patients with worse baseline PVR (p=0.016). Survival was similar at both one and three years. On subsequent analysis, moderate/severe TR was associated with worse survival. MCS implantation as a bridge to OHT has good one and three-year outcomes among patients with increasing pre-MCS PVR. However, patients with severe PH prior to MCS have an increased rate of TR. Among these patients, moderate-severe TR after OHT has an associated risk of early death.
SN  - 2577-5820
UR  - https://doi.org/10.21926/obm.transplant.2003114
DO  - 10.21926/obm.transplant.2003114
ID  - Emerson2020
ER  -