医学
肺
吻合
肺移植
移植
左肺动脉
肺动脉
放射科
右肺动脉
内科学
并发症
外科
心脏病学
作者
Nicolas Kumar,Nasir Hussain,Julia E. Kumar,Michael Essandoh,Amar Bhatt,Hamdy Awad,William Pérez,Bryan A. Whitson,Asvin M. Ganapathi,Nahush A. Mokadam,Leonid Gorelik,Katja Turner,Manoj H. Iyer
出处
期刊:Transplantation
[Ovid Technologies (Wolters Kluwer)]
日期:2020-08-04
卷期号:105 (4): 711-722
被引量:7
标识
DOI:10.1097/tp.0000000000003407
摘要
Pulmonary artery obstruction is an uncommon but significant complication after lung transplantation. Although numerous reports have documented its occurrence, the hemodynamic parameters associated with its presentation and diagnostic considerations remain ill-defined. This systematic review summarizes evidence in the literature surrounding pulmonary artery obstruction after lung transplantation surgery.Databases were searched for all articles and abstracts reporting on pulmonary artery obstruction. Data collected included the number of patients studied, patient characteristics, incidences of pulmonary artery obstruction, and timing and imaging modality used for diagnosis.Thirty-four full-text citations were included in this review. The point prevalence of pulmonary artery obstruction was 3.66%. The peak pulmonary artery velocity associated with obstruction was found to be 2.60 ± 0.58 m/s. The diameter of the obstructed pulmonary artery predictive of poor outcomes was noted to be 0.78 ± 0.40 cm. The majority of diagnoses were made in the late postoperative period using pulmonary angiogram and transesophageal echocardiography. Overall, 76% of patients (47 of 62) required emergent procedural reintervention, and 23% of patients (14 of 62) diagnosed with pulmonary artery obstruction died during their hospital stay.This systematic review underscores the importance of identifying pulmonary artery obstruction immediately after lung transplant surgery. The clinical implications of these results warrant the development of identification and management strategies for early detection of irregularities in pulmonary artery anastomosis in lung transplant patients.
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