Heart Transplant: Single Lung Physiology

Lamour, JM, et al. (from Columbia, NY)

J Heart Lung Transplant 2004;23:948-53

11 patients with single lung physiology from congenital heart disease.

TOF with absent LPA - 4,

Single Ventricle s/p Classic Glenn - 7 (Absent LPA 1, Severe LPA hypertension 6)

Cause of LPA hypertension in the 6 pts:

Pulmonary vein stenosis 3, Waterston shunt 1 and AP collateral 2.

Preop. mean RPA pressure:

TOF patients - 29 ± 10 mmHg

Classic Glenn patients - 15 ± 4 mmHg

PA angiograms showed normal branch pattern of RPA.

Lung perfusion scan showed 80% flow to right lung in patients with LPA hypertension.

Age range at Heart Transplant: 9 - 43 yrs.

Outcome:

Early postop death 2 (Aortic rupture 1, Bleeding 1) - 82% operative survival.

Late death 1 (Rejection at 3 yrs)

8/11 are alive at 4 yrs.

LPA continuity was established in 6 pts: Post-op lung perfusion scan did not show increase in flow to LPA.