Analysis of early hemodynamic changes after orthotopic heart transplantation / 中华器官移植杂志

ABSTRACT

Objective To review the clinical changes and the management experience of hemodynamics after orthotopic heart transplantation.Methods Orthotopic homologous heart transplantation was performed on 25 cases from January 2000 to October 2003. The hemodynamic changes were monitored after operation with Swan-Ganz catheter and color Dopplor ultrasound. The therapy strategy was regulated when the monitor index and the clinical situation were referenced.Results PAWP, PASP, CVP, CO and CI were increased on the operation day. From the first day to the 7th day, PAWP, PASP and CVP were increased with right ventricle enlarged and sometimes arrhythmia and hydrothorax occurred. After strengthening heart, diuresis and stretching vessel, the hemodynamic changes of 23 cases were inversed and two cases’ conditions got worse. The two patients died of multiple organ failure on the 16th and 23rd day respectively.Conclusion The hemodynamic changes often occur at the early term after orthotopic heart transplantation. The main change is the right ventricular failure. It is important for the patient’s condition recovery and prognosis to monitor the hemodynamic changes and analyze the cause in order to direct the therapy.