Perfil hemodinâmico e neuro-hormonal durante assistência circulatória com ventrículo artificial heterotópico seguida de transplante cardíaco / Neurohormonal and Hemodynamic data During Heterotopic Ventricular Assist Device System Support as a Bridge to Heart Transplantation

RESUMO

We describe the hemodynamic and neurohormonal data during ventricular assistance device system support as a bridge to heart transplantation of one patient, 30 years old, with heart failure due to Chagas' heart disease in functional class IV. We determined the pressures in mmHg of right atrium (RA), pulmonary artery pressure (PAP), pulmonary wedge pressure (WEDGE), arterial blood pressure (AP), and the cardiac output (CO) in l/min. In addition, the blood levels of norepinephrine (Ne), renin (Re), epinephrine (Ep), lactate and the mixed venous oxygen pressure (pVO2) were determined. The CO increased from 2.14 to 3.9-4.2 l/min, the AD decreased from 26mmHg to 8mmHg, the MPAP reduced from 38mmHg to 14-24mmHg, the WEDGE reduced from 25 to 4mmHg and the AP become normal. The Ne reduced from 1927pg/ml to 983pg/ml, the lactate reduced from 99mg/dl to 22mg/dl and the pVO2 increased from 28mmHg to 43mmHg. The EP remained between 81pg/ml and 129pg/ml, the renin activity remained between 113ng/ml/hr and 136ng/ml/hr. Thus, during the ventricular assistance device system support there was a improvement in hemodynamic and neurohormonal conditions. The patient underwent successful heart transplantation