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Lung Transplantation of a Patient with Pulmonary Hypertension

Hristo Draganov, Kristina Dimitrova, Hristina Pamukchiyska, Elena Harizanova, Diana Petkova

Abstract

Introduction: Pulmonary hypertension is a condition that is characterised by increase in the blood pressure in the pulmonary artery above 25 mmHg at rest and above 30 mmHg during exercise. The disease has a poor prognosis and is fatal despite contemporary treatment.

Materials and Methods: We present a case of a 36-year-old man, complaining of progressive dyspnea and dry irritating cough. At the age of 3, he had a surgical intervention for persistent ductus arteriosus. In 2011, he was diagnosed with paralysis of the left vocal fold and high-degree pulmonary arterial hypertension. A number of noninvasive and invasive tests, among which electrocardiography, echocardiography and chest CT scan with contrast, were performed.

Results: The results from these tests revealed high pressure in the right ventricle and in the right atrium, severe tricuspid regurgitation, blood pressure of 80 mmHg in the pulmonary artery (above normal), 6 MWDT 316m and dyspnea that required breaks during the test. The final diagnosis was pulmonary arterial hypertension – group I, and targeted treatment with Tracleer and Revatio was started in addition to diuretic therapy. Anticoagulants were not included, because of recurrent episodes of hemoptoe. Despite the treatment, progression of the disease required further actions to be taken. Thus, in 2016 the patient was assessed as a suitable candidate for lung transplantation and the procedure was performed in Vienna. After the surgery, the quality of life and physical state of the patient improved.

Conclusion: Early diagnosis and adequate treatment greatly improve the prognosis and the quality of life of patients with pulmonary arterial hypertension.


Keywords

pulmonary arterial hypertension, lung transplantation


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