218 Not the Right, but the Left Ventricle Causes the Problem after Lung Transplantation for Pulmonary Artery Hypertension – Awake ECMO for Postoperative LV Remodelling

Acute myocardial infarction (AMI) resulting in cardiogenic shock continues to be a substantial source of morbidity and mortality despite advances in recognition and treatment. Prior to the advent of percutaneous and more durable left ventricular support devices, prompt revascularization with the addition of vasopressors and inotropes were the standard of care in the management of this critical population. Recent published studies have shown that in addition to prompt revascularization, unloading of the left ventricle with the placement of the Impella percutaneous axillary flow pump can lead to improvement in mortality. Parameters such as the cardiac power output (CPO) and pulmonary artery pulsatility index (PAPi), obtained through pulmonary artery catheterization, can help ascertain the productivity of right and left ventricular function. Utilization of these parameters can provide the information necessary to escalate support to the right ventricle with the insertion of an Impella RP or the left ventricle with the insertion of larger devices, which provide more forward flow. Herein, we present a case of AMI complicated by cardiogenic shock resulting in biventricular failure treated with the percutaneous insertion of an Impella RP and Impella 5.0 utilizing invasive markers of left and right ventricular function to guide the management and escalation of care.

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Relationship Between the Right Ventricular Pressure Waveform and the Vasodilator Response of Pulmonary Artery Pressure in Pulmonary Artery Hypertension

Korean Circulation Journal ◽

10.4070/kcj.2003.33.11.1011 ◽

2003 ◽

Vol 33 (11) ◽

pp. 1011 ◽

Cited By ~ 1

Author(s):

Jun Hee Lee ◽

Yong Jin Kim ◽

Dae Won Sohn ◽

Byoung Hee Oh ◽

Myoung Mook Lee ◽

...

Keyword(s):

Pulmonary Artery ◽

Right Ventricular ◽

Pulmonary Artery Pressure ◽

Pulmonary Artery Hypertension ◽

Ventricular Pressure ◽

Pressure Waveform ◽

Artery Pressure ◽

Vasodilator Response ◽

The Right

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Transient Pulmonary Artery Hypertension in Holstein Neonate Calves

Animals ◽

10.3390/ani10122277 ◽

2020 ◽

Vol 10 (12) ◽

pp. 2277

Author(s):

Melina Marie Yasuoka ◽

Bruno Moura Monteiro ◽

Paulo Fantinato-Neto ◽

Renan Braga Paiano ◽

Denise Tabacchi Fantoni ◽

...

Keyword(s):

Pulmonary Artery ◽

Blood Gases ◽

Pulmonary Artery Hypertension ◽

Right Atrial ◽

Arterial Blood ◽

Pulmonary Capillary ◽

Neonatal Adaptation ◽

Holstein Calves ◽

Phase Constant ◽

The Right

The neonatal period is a challenging phase for calves, and during this phase constant adaptations are required. The aim of the present study was to evaluate the invasive hemodynamics with the Swan-Ganz catheter in neonate calves to understand adaptive changes during the first 30 days of life. A prospective and observational study was conducted with 10 Holstein calves. Assessments of the right atrial pressure (RAP), right ventricular pressure (RVP), pulmonary artery pressure (PAP), pulmonary capillary pressure (PW), cardiac output (CO), heart rate (HR), pulmonary vascular resistance (PVR), and blood gas levels were performed. The analyses of PAP, PVR, PW, HR, sO2, and arterial blood gases differed (p < 0.05) between the evaluated periods. Our results indicated transient pulmonary artery hypertension during the process of extrauterine adaptation during the first 30 days of life. This hypertension must be considered as physiological and consequent to the neonatal adaptation process.

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Novel technique of repairing right partial anomalous pulmonary venous connection with intact atrial septum using in situ interatrial septum as a flap in a 68-year-old-woman: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01313-w ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Atsushi Morishita ◽

Ikuo Hagino ◽

Hideyuki Tomioka ◽

Seiichiro Katahira ◽

Takeshi Hoshino ◽

...

Keyword(s):

Pulmonary Artery ◽

Right Atrium ◽

Septal Defect ◽

Surgical Repair ◽

Interatrial Septum ◽

Pulmonary Artery Hypertension ◽

Right Heart ◽

Intact Atrial Septum ◽

The Right ◽

Anomalous Pulmonary Venous Connection

Abstract Background Partial anomalous pulmonary venous connection draining into the right atrium with an intact atrial septum is a very rare clinical entity in the adult population. Partial anomalous pulmonary venous connection must be suspected as a differential diagnosis when the cause of right heart enlargement and pulmonary artery hypertension is unknown. Case presentation This study describes the surgical case of an isolated right partial anomalous pulmonary venous connection to the right atrium in a 68-year-old woman, who underwent tricuspid ring annuloplasty and right-sided maze procedure simultaneously. She had complaints of gradually progressing dyspnea on exertion. However, a diagnosis could not be established despite consultations at multiple hospitals for over a year. Right heart catheterization revealed severe pulmonary artery hypertension with a mean pulmonary artery pressure of 46 mmHg, step-up phenomenon of oxygen saturation at the mid-level of the right atrium with a pulmonary-to-systemic blood flow ratio of 2.4, and a pulmonary vascular resistance of 3.1 Wood Units. As medical treatment with pulmonary artery vasodilator therapy did not improve her symptoms, she underwent surgical repair. An atrial septal defect was created surgically with a curvilinear tongue-shaped cut. The right anomalous pulmonary veins were rerouted through the surgically created atrial septal defect into the left atrium with a baffle comprised of the interatrial septum flap, kept in continuity with the anterior margin and sutured while mobilizing the enlarged right atrium. The patient had an uneventful postoperative course and remains asymptomatic. Conclusions The described surgical technique could be considered an effective alternative for patients undergoing surgical repair for a partial anomalous pulmonary venous connection isolated to the right atrium. The indication for surgery must be judged on a case-by-case basis in these patients with prevalent systemic-to-pulmonary shunting.

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