Kidney transplantation in valvular heart disease and pulmonary hypertension: Consensus in waiting

2020 ◽  
Author(s):  
Ajay Kumar Jha ◽  
Suman Lata
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Kidney Transplantation ◽  
Valvular Heart Disease

scholarly journals Persistent Pulmonary Hypertension in Corrected Valvular Heart Disease: Hemodynamic Insights and Long‐Term Survival

2021 ◽  
Author(s):  
Javier Bermejo ◽  
Ana González‐Mansilla ◽  
Teresa Mombiela ◽  
Ana I. Fernández ◽  
Pablo Martínez‐Legazpi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Valvular Heart Disease ◽  
Pulmonary Artery Wedge Pressure ◽  
Wedge Pressure

Background The determinants and consequences of pulmonary hypertension after successfully corrected valvular heart disease remain poorly understood. We aim to clarify the hemodynamic bases and risk factors for mortality in patients with this condition. Methods and Results We analyzed long‐term follow‐up data of 222 patients with pulmonary hypertension and valvular heart disease successfully corrected at least 1 year before enrollment who had undergone comprehensive hemodynamic and imaging characterization as per the SIOVAC (Sildenafil for Improving Outcomes After Valvular Correction) clinical trial. Median (interquartile range) mean pulmonary pressure was 37 mm Hg (32–44 mm Hg) and pulmonary artery wedge pressure was 23 mm Hg (18–26 mm Hg). Most patients were classified either as having combined precapillary and postcapillary or isolated postcapillary pulmonary hypertension. After a median follow‐up of 4.5 years, 91 deaths accounted for 4.21 higher‐than‐expected mortality in the age‐matched population. Risk factors for mortality were male sex, older age, diabetes mellitus, World Health Organization functional class III and higher pulmonary vascular resistance—either measured by catheterization or approximated from ultrasound data. Higher pulmonary vascular resistance was related to diabetes mellitus and smaller residual aortic and mitral valve areas. In turn, the latter correlated with prosthetic nominal size. Six‐month changes in the composite clinical score and in the 6‐minute walk test distance were related to survival. Conclusions Persistent valvular heart disease–pulmonary hypertension is an ominous disease that is almost universally associated with elevated pulmonary artery wedge pressure. Pulmonary vascular resistance is a major determinant of mortality in this condition and is related to diabetes mellitus and the residual effective area of the corrected valve. These findings have important implications for individualizing valve correction procedures. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00862043.

Pulmonary Hypertension Due to Valvular Heart Disease: Aortic and Mitral

2015 ◽  
Vol 14 (2) ◽  
pp. 95-101
Author(s):  
Ryan Karl Kaple ◽  
Evelyn M. Horn
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Aortic Valve ◽  
Valvular Heart Disease ◽  
Treatment Options ◽  
Venous Hypertension ◽  
Pulmonary Vasculature ◽  
Pulmonary Vascular Disease ◽  
Surgical Interventions ◽  
Valve Lesions

Pulmonary hypertension (PH) can be due to a primary pulmonary vasculature abnormality, but is more often secondary to lung, cardiac, or environmental insults, and is frequently multifactorial. Most commonly, left heart disease is at fault, a subset of which is valvular heart disease (VHD). With sufficient time, most chronic left-sided valve lesions will result in some element of PH. Long-standing PH causes pulmonary vascular remodeling and progressive PH due to reduced vascular compliance. Careful monitoring of VHD progression is critical, both through screening imaging and patient education, in order to properly time intervention to prevent the development or worsening of PH. The primary diagnostic tool in PH due to VHD is echocardiography, while invasive hemodynamic evaluation can be helpful to determine PH etiology or severity when echocardiography is not adequate. The presence of PH in VHD is often an indication for intervention, but it also increases procedural risk. Severe PH, however, has not been proven to preclude safe intervention, but rather should prompt full preprocedural evaluation and close intra- and postprocedural monitoring. Valve replacement or repair can be viewed as a treatment for PH secondary to the valvular lesion. Percutaneous alternatives to surgical interventions are available for some mitral and aortic valve conditions. Though in relatively early stages of development, these less invasive procedures may improve the safety profile of valve interventions. Pulmonary hypertension that fails to improve after intervention should raise suspicion for procedural failure or underlying pulmonary vascular disease (either precapillary possibly in association with interstitial lung disease or scleroderma or secondary to combined pre-/postcapillary PH due to long-standing pulmonary venous hypertension). This review is focused on the pathophysiology, treatment options, and outcomes in patients with PH due to mitral and aortic valve lesions.

Does Milrinone Improve Hemodynamic Variables in Patients with Pulmonary Hypertension Due to Valvular Heart Disease?

2003 ◽  
Vol 44 (2) ◽  
pp. 187
Author(s):  
Yon Hee Shim ◽  
Young Jun Oh ◽  
Sang Beom Nam ◽  
Esther Kim ◽  
Yong Woo Hong ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Hemodynamic Variables

scholarly journals Fatal postoperative systemic pulmonary hypertension in benfluorex-induced valvular heart disease surgery

Medicine ◽  
2017 ◽  
Vol 96 (2) ◽  
pp. e4985 ◽  
Author(s):  
Christophe Baufreton ◽  
Patrick Bruneval ◽  
Marie-Christine Rousselet ◽  
Pierre-Vladimir Ennezat ◽  
Olivier Fouquet ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Valvular Heart Disease

scholarly journals Inhaled Nitric Oxide in Patients With Pulmonary Hypertension Due to Valvular Heart Disease and Chronic Lung Disease

1998 ◽  
Vol 62 (12) ◽  
pp. 877-882
Author(s):  
Michiko Sakane ◽  
Toshiyuki Ishimitsu ◽  
Hiroki Ninomiya ◽  
Itaru Ohtsu ◽  
Toshihiko Saito ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Valvular Heart Disease ◽  
Inhaled Nitric Oxide

PULMONARY HYPERTENSION AND VALVULAR HEART DISEASE: INCIDENCE AND IMMEDIATE IMPACT OF SURGICAL REPAIR

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 623A
Author(s):  
Adam N. Hurewitz ◽  
Mary Bartlett ◽  
Alex Shalshin ◽  
Scott Schubach
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Valvular Heart Disease ◽  
Surgical Repair ◽  
Disease Incidence

Management of valvular heart disease: Role of echocardiography and assessment of pulmonary hypertension reversibility

2014 ◽  
Vol 23 ◽  
pp. e28-e29
Author(s):  
K. Khokhar ◽  
G. Devlin ◽  
A. El-Gamel ◽  
R. Fisher ◽  
P. Jogia
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Valvular Heart Disease
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