ECHOCARDIOGRAPHIC ASSESSMENT OF RIGHT AND LEFT-VENTRICULAR FUNCTION AFTER SINGLE-LUNG TRANSPLANTATION

To, evaluate the impact of single-lung transplantation on right and le ft ventricular performance and to identify potential preoperative char acteristics that could predict postoperative outcome, a large group of patients were retrospectively evaluated by means of serial Doppler ec hocardiography. Twenty-six of 57 consecutive single-lung transplant pa tients had satisfactory Doppler echocardiographic studies before and a fter surgery. A significant reduction in right ventricular diastolic a nd systolic areas and an increase in right ventricular fractional area were noted after transplantation. The left ventricular contractility remained unchanged. In addition, significant reduction in right atrial area, right ventricular free wall thickness, and tricuspid regurgitat ion were also seen. Paradoxical septal motion present in eight patient s before the procedure resolved in all of them after single-lung trans plantation. Transthoracic echocardiography is a useful technique to do cument improvement in right ventricular function in 63% of patients fo llowing single-lung transplantation. Preoperative paradoxical septal m otion identifies single-lung transplant recipients who have the larges t postoperative right ventricular area reduction and fractional area i ncrease. Alternative imaging modalities should be sought for single-lu ng transplant candidates in whom conventional transthoracic echocardio graphy is suboptimal.