Single lung transplantation and ventricular septal defect repair for Eisenmenger syndrome: report of one case / 中华器官移植杂志

ABSTRACT

Objective To evaluate the operative technique,perioperative management and ontcome of single lung transplantation and ventricular septal defect repair for Eisenmenger syndrome.Methods A 16 years old male patient with end-stage ventricular septal defect who received open heart exploration 12 years ago underwent right single lung transplantation and ventricular septal defect repair on Oct.22,2004.The operation was carried out under cardiopulmonary bypass(CPB) with beating heart.The donor lung was perfused with modified LPD solution.Tacrolimus(FK506),mycophenolate mofetil (MMF) and corticosteroid regime was used for immunosuppressive therapy.CPB time was 244 min,and donor lung ischemic time was 6 h.Results During the operation,the pulmonary artery pressure was reduced from 110/60 mm Hg to 53/39 mm Hg after transplantation.The patient weaned from the ventilator at the 12th postoperative day.An acute rejection episode occurred on the 14th postoperative day.ICU stay was 30 days.99m-Tc-MAA pulmonary perfusion scan demonstrated predominant right lung blood flow.UCG assessed improved heart functions,intact ventricular septum and mean pulmonary artery pressure of 45 mm Hg.The exercise tolerance was prominently improved.The patient was discharged on the 62nd day after transplantation.Conclusions Single lung transplantation and congenital heart defect repair is effective for end-stage left-to-right shunt congenital heart diseases with satisfying short-term results.Closed follow-up and surveillance are needed for long-term outcomes.