The disappearing left ventricle: A double lung transplant in a patient with severe pulmonary hypertension

Kerry K. Blaha, Dan Berkowitz

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The case The patient is a 43-year-old female who has had a history of idiopathic pulmonary hypertension for many years. Her home treatment regimen consisted of numerous medications, including a continuous IV infusion of Flolan delivered by a patient-controlled pump. A recent echocardiogram revealed a RVSP (right ventricular systolic pressure) of 127 mmHg, and right heart catheterization was significant for pulmonary artery pressures greater than her systemic blood pressures. A decline in her functional status over the past 2 weeks landed her a top spot on the lung transplant list and a “luxurious” room on Osler 4. She is the youngest of many children and is surrounded by her entire family awaiting the news: will these lungs be good enough? She has been in this position before, anxiously anticipating her new set of lungs. She has been disappointed once before and remembers the words “I'm sorry, but it's a no-go” all too clearly. You thoroughly discuss the anesthetic plan with the patient and her family. They are quite intelligent and ask some pretty in-depth questions. You breathe a sigh of relief as you answer the final question. You explain that you will take excellent care of the patient as you try to put them at ease. They smile, and you feel as if you gained their trust. However, now that their fears have been allayed, you can't help but feel anxious yourself about the monumental task you have ahead: the responsibility of getting her safely through the operation.

Original languageEnglish (US)
Title of host publicationCore Clinical Competencies in Anesthesiology
Subtitle of host publicationA Case-Based Approach
PublisherCambridge University Press
Pages391-396
Number of pages6
ISBN (Electronic)9780511730092
ISBN (Print)9780521144131
DOIs
StatePublished - Jan 1 2010

ASJC Scopus subject areas

  • Medicine(all)

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