Right ventricular failure and pulmonary hypertension at recurrent thromboembolism of small branches of the pulmonary artery in cancer patients

Aim. Develop new approaches to the diagnosis of right heart failure and pulmonary hypertension in recurrent thromboembolism of small branches of the pulmonary artery in patients with malignant tumors. Methods. 83 patients with malignant tumors of various localizations were examined and followed-up. The main group included 49 patients with malignant tumors of various localizations and related venous thrombosis. The control group included 34 patients who did not have venous thrombosis. Patients in both groups underwent ultrasonography of inferior vena cava system veins and echocardiography at intervals of 3-4 days during the diagnosis and treatment of malignant tumors. Right ventricle ejection fraction and systolic pressure in the pulmonary artery were calculated at echocardiography. Results. No signs of inferior vena cava system veins thromboses, right heart failure, pulmonary hypertension were identified in patients of the control group while setting up the diagnosis and treatment of malignancies. In 38 out of 49 patients of the main group, right ventricular failure and pulmonary hypertension of varying severity were detected. The condition of 46 patients of the main group gradually improved after treating with anticoagulants. Conclusion. Recanalization of venous thrombosis is accompanied by frequent rejection of micro thrombi and embolization of small branches of pulmonary artery, causing right heart failure and pulmonary hypertension, which can be promptly detected by repeated echocardiography.

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Unilateral interruption of pulmonary artery with pulmonary hypertension: a case for heart lung transplantation?

Cardiology in the Young ◽

10.1017/s1047951119000271 ◽

2019 ◽

Vol 29 (5) ◽

pp. 704-707 ◽

Cited By ~ 1

Author(s):

Roopesh Singhal

Keyword(s):

Heart Failure ◽

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Lung Transplantation ◽

Congenital Heart ◽

Right Heart Failure ◽

Adverse Outcomes ◽

Severe Pulmonary Hypertension ◽

Right Heart ◽

Right Pulmonary Artery

AbstractUnilateral interruption of pulmonary artery is a rare congenital anomaly which is usually associated with other congenital heart disease. Even more rarely it may occur in isolation. Most of the cases are incidentally detected in adulthood. Some cases develop pulmonary hypertension for yet unknown reasons; such cases usually present in infancy with right heart failure. Surgical correction in such cases is associated with adverse outcomes. Heart lung transplantation should be considered in such patients. We report a 3-year-old boy with interruption of right pulmonary artery with severe pulmonary hypertension and right heart failure who was considered for heart lung transplantation.

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Chronic Thromboembolic Pulmonary Hypertension

Seminars in Interventional Radiology ◽

10.1055/s-0038-1651481 ◽

2018 ◽

Vol 35 (02) ◽

pp. 136-142 ◽

Cited By ~ 2

Author(s):

G. Pretorius ◽

Stuart Jamieson

Keyword(s):

Heart Failure ◽

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Pulmonary Arteries ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Right Heart Failure ◽

Scar Tissue ◽

Right Heart ◽

Fibrotic Scar ◽

Thromboembolic Pulmonary Hypertension

AbstractChronic thromboembolic pulmonary hypertension occurs when acute thromboemboli fail to dissolve completely. The resulting fibrotic scar tissue within the pulmonary arteries is obstructive and eventually leads to right heart failure. Medical therapy for this condition is supportive, but surgery with pulmonary artery endarterectomy is curative, and carries a low mortality at experienced centers.

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Pre-operative pulmonary artery pulsatility index does not predict mortality post cardiac transplantation but PVR is a prognostic tool in LVAD-bridged patients

European Heart Journal ◽

10.1093/ehjci/ehaa946.2228 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

N Bart ◽

S.L Hungerford ◽

S Emmanuel ◽

K Kearney ◽

E Kotlyar ◽

...

Keyword(s):

Heart Failure ◽

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Pulsatility Index ◽

Cardiac Transplantation ◽

Right Heart Failure ◽

Right Heart ◽

Post Transplant ◽

Significant Difference

Abstract The Pulmonary artery pulsatility index (PAPi) is a novel haemodynamic marker that has been shown to be a strong predictor of right heart failure and mortality in patients with pulmonary hypertension and advanced heart failure. Its utility in predicting post transplant outcomes is currently unknown. Aim To determine the prognostic significance of pre-transplant haemodynamic assessment of PAPi, right atrial pressure (RA), and pulmonary vascular resistance (PVR) in predicting mortality post cardiac transplant. Methods All patients who underwent cardiac transplantation between January 2010 and June 2016 were retrospectively analyzed. Pre-operative right heart catheter data was obtained. The PAPi was calculated as the systolic pulmonary artery pressure (sPAP)- diastolic pulmonary artery pressure (dPAP) divided by RA. Statistical analysis was carried out using SPSS v25. Results A total of 158 patients, with a mean age of 48.6±13.5 were studied (115 non- LVAD, 43 LVAD pre-transplant), and 3 patients were excluded due to missing data. There was no significant difference in the non-LVAD group in RA, PVR or PAPi for mortality post transplant. In the LVAD group there was no significant difference in RA, or PAPi with regards to mortality, however there was a significant difference in mean PVR between those that died post transplant (222±100) and those still alive (138±59) Conclusion Despite having a role in prognostication for right heart failure in pulmonary hypertension and post LVAD implantation, PAPi did not discriminate mortality outcomes for patients post cardiac transplantation. PVR remains a marker of mortality in an LVAD cohort bridged to transplant. Funding Acknowledgement Type of funding source: None

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Takayasu’s Arteritis Mimicking Unilateral Pulmonary Artery Agenesis in a Child With Severe Pulmonary Hypertension and Right Heart Failure: A Diagnostic Dilemma

Pediatric Cardiology ◽

10.1007/s00246-011-0025-6 ◽

2011 ◽

Vol 32 (7) ◽

pp. 993-997 ◽

Cited By ~ 3

Author(s):

Sudeep Kumar ◽

Nagaraja Moorthy ◽

Aditya Kapoor ◽

Sunil Kumar

Keyword(s):

Heart Failure ◽

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Takayasu’S Arteritis ◽

Right Heart Failure ◽

Severe Pulmonary Hypertension ◽

Right Heart ◽

Diagnostic Dilemma ◽

Unilateral Pulmonary Artery Agenesis ◽

Pulmonary Artery Agenesis

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Acute and Long-Term Hemodynamic Effects of MitraClip Implantation on a Preexisting Secondary Right Heart Failure

BioMed Research International ◽

10.1155/2018/6817832 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

M. Hünlich ◽

E. Lubos ◽

B. E. Beuthner ◽

M. Puls ◽

A. Bleckmann ◽

...

Keyword(s):

Heart Failure ◽

Pulmonary Hypertension ◽

Pulmonary Artery ◽

Pulmonary Artery Pressure ◽

Tricuspid Regurgitation ◽

Right Heart Failure ◽

Right Atrial ◽

Right Heart ◽

Artery Pressure

Positive results of MitraClip in terms of improvement in clinical and left ventricular parameters have been described in detail. However, long-term effects on secondary pulmonary hypertension were not investigated in a larger patient cohort to date. 70 patients with severe mitral regurgitation, additional pulmonary hypertension, and right heart failure as a result of left heart disease were treated in the heart centers Hamburg and Göttingen. Immediately after successful MitraClip implantation, a reduction of the RVOT diameter from 3.52 cm to 3.44 cm was observed reaching a statistically significant value of 3.39 cm after 12 months. In contrast, there was a significant reduction in the velocity of the tricuspid regurgitation (TR) from 4.17 m/s to 3.11 m/s, the gradient of the TR from 48.5 mmHg to 39.3 mmHg, and the systolic pulmonary artery pressure (PAPsyst) from 58.6 mmHg to 50.0 mmHg. This decline continued in the following months (Vmax TR 3.09 m/s, peak TR 38.6 mmHg, and PAPsyst 47.4 mmHg). The tricuspid annular plane systolic excursion (TAPSE) increased from 16.5 mm to 18.9 mm after 12 months. MitraClip implantation improves pulmonary artery pressure, tricuspid regurgitation, and TAPSE after 12 months. At the same time, there is a decrease in the RVOT diameter without significant changes in other right ventricular and right atrial dimensions.

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