Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA)
Patients with pulmonary arterial hypertension (PAH) become candidates for lung or lung and heart transplantation when the maximum specific therapy is no longer effective. The most difficult challenge is choosing one of the above options in the event of symptoms of right ventricular failure. Here, we...
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MDPI AG
2022-12-01
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author | Tomasz Stącel Paweł Sybila Agata Mędrala Marek Ochman Magdalena Latos Fryderyk Zawadzki Anna Pióro Piotr Pasek Piotr Przybyłowski Tomasz Hrapkowicz Ewa Mroczek Agnieszka Kuczaj Grzegorz Kopeć Roland Fiszer Szymon Pawlak Anita Stanjek-Cichoracka Maciej Urlik |
author_facet | Tomasz Stącel Paweł Sybila Agata Mędrala Marek Ochman Magdalena Latos Fryderyk Zawadzki Anna Pióro Piotr Pasek Piotr Przybyłowski Tomasz Hrapkowicz Ewa Mroczek Agnieszka Kuczaj Grzegorz Kopeć Roland Fiszer Szymon Pawlak Anita Stanjek-Cichoracka Maciej Urlik |
author_sort | Tomasz Stącel |
collection | DOAJ |
description | Patients with pulmonary arterial hypertension (PAH) become candidates for lung or lung and heart transplantation when the maximum specific therapy is no longer effective. The most difficult challenge is choosing one of the above options in the event of symptoms of right ventricular failure. Here, we present two female patients with PAH: (1) a 21-year-old patient with Eisenmenger syndrome, caused by a congenital defect—patent ductus arteriosus (PDA); and (2) a 39-year-old patient with idiopathic PAH and coexistent PDA. Their common denominator is PDA and the hybrid surgery performed: double lung transplantation with simultaneous PDA closure. The operation was performed after pharmacological bridging (conditioning) to transplantation that lasted for 33 and 70 days, respectively. In both cases, PDA closure effectiveness was 100%. Both patients survived the operation (100%); however, patient no. 1 died on the 2nd postoperative day due to multi-organ failure; while patient no. 2 was discharged home in full health. The authors did not find a similar description of the operation in the available literature and PubMed database. Hence, we propose this new treatment method for its effectiveness and applicability proven in our practice. |
first_indexed | 2024-03-09T16:16:49Z |
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institution | Directory Open Access Journal |
issn | 2308-3425 |
language | English |
last_indexed | 2024-03-09T16:16:49Z |
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series | Journal of Cardiovascular Development and Disease |
spelling | doaj.art-6319dc87a84a4a8daeb1349c3bd29a612023-11-24T15:42:08ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-12-0191245710.3390/jcdd9120457Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA)Tomasz Stącel0Paweł Sybila1Agata Mędrala2Marek Ochman3Magdalena Latos4Fryderyk Zawadzki5Anna Pióro6Piotr Pasek7Piotr Przybyłowski8Tomasz Hrapkowicz9Ewa Mroczek10Agnieszka Kuczaj11Grzegorz Kopeć12Roland Fiszer13Szymon Pawlak14Anita Stanjek-Cichoracka15Maciej Urlik16Silesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac Anaesthesia and Intensive Care, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandInstitute of Heart Diseases, University Clinical Hospital Mikulicz Radecki in Wroclaw, ul. Borowska 213, 50-558 Wroclaw, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandPulmonary Circulation Centre, Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Congenital Heart Defects and Pediatric Cardiology, Medical University of Silesia, 40-055 Katowice, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Biophysics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jedności 8, 41-200 Sosnowiec, PolandSilesian Centre for Heart Diseases in Zabrze, Department of Cardiac, Vascular and Endovascular Surgery, and Transplantology, Medical University of Silesia, 40-055 Katowice, PolandPatients with pulmonary arterial hypertension (PAH) become candidates for lung or lung and heart transplantation when the maximum specific therapy is no longer effective. The most difficult challenge is choosing one of the above options in the event of symptoms of right ventricular failure. Here, we present two female patients with PAH: (1) a 21-year-old patient with Eisenmenger syndrome, caused by a congenital defect—patent ductus arteriosus (PDA); and (2) a 39-year-old patient with idiopathic PAH and coexistent PDA. Their common denominator is PDA and the hybrid surgery performed: double lung transplantation with simultaneous PDA closure. The operation was performed after pharmacological bridging (conditioning) to transplantation that lasted for 33 and 70 days, respectively. In both cases, PDA closure effectiveness was 100%. Both patients survived the operation (100%); however, patient no. 1 died on the 2nd postoperative day due to multi-organ failure; while patient no. 2 was discharged home in full health. The authors did not find a similar description of the operation in the available literature and PubMed database. Hence, we propose this new treatment method for its effectiveness and applicability proven in our practice.https://www.mdpi.com/2308-3425/9/12/457pulmonary arterial hypertensionpatent ductus arteriosusheart transplantationlung transplantationECMOconditioning and bridging to lung transplantation |
spellingShingle | Tomasz Stącel Paweł Sybila Agata Mędrala Marek Ochman Magdalena Latos Fryderyk Zawadzki Anna Pióro Piotr Pasek Piotr Przybyłowski Tomasz Hrapkowicz Ewa Mroczek Agnieszka Kuczaj Grzegorz Kopeć Roland Fiszer Szymon Pawlak Anita Stanjek-Cichoracka Maciej Urlik Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA) Journal of Cardiovascular Development and Disease pulmonary arterial hypertension patent ductus arteriosus heart transplantation lung transplantation ECMO conditioning and bridging to lung transplantation |
title | Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA) |
title_full | Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA) |
title_fullStr | Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA) |
title_full_unstemmed | Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA) |
title_short | Novel Hybrid Treatment for Pulmonary Arterial Hypertension with or without Eisenmenger Syndrome: Double Lung Transplantation with Simultaneous Endovascular or Classic Surgical Closure of the Patent Ductus Arteriosus (PDA) |
title_sort | novel hybrid treatment for pulmonary arterial hypertension with or without eisenmenger syndrome double lung transplantation with simultaneous endovascular or classic surgical closure of the patent ductus arteriosus pda |
topic | pulmonary arterial hypertension patent ductus arteriosus heart transplantation lung transplantation ECMO conditioning and bridging to lung transplantation |
url | https://www.mdpi.com/2308-3425/9/12/457 |
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