CARDIOLOGICAL PROBLEMS IN FOLLOW-UP OF PATIENTS WITH CYSTIC-FIBROSIS AFTER LUNG TRANSPLANTATION

We report the cardiovascular complications of bilateral sequential lun g transplantation in 13 patients (9 female and 4 male; mean age 26 +/- 6 years) with cystic fibrosis followed up for 9 +/- 5 months. Three p atients had pulmonary hypertension (mean pulmonary artery pressure > 2 5 mmHg) and moderate right ventricular dysfunction at preoperative eva luation. During surgery no patients had the need for extra-corporeal c irculation. Intraoperative transesophageal echocardiography demonstrat ed good vascular anastomosis in all patients. One patient died in crit ical care unit for non cardiac cause. During the in-hospital period 2 patients had severe diffuse edema. The first patient, with a preserved RV function, had a fast recovery with proper therapy. The second one, who had increased pulmonary vascular resistance and moderate RV dysfu nction, had an episode of pulmonary edema and a slow recovery. Subsequ ently he died at 45 post operative day for sepsis and renal failure. E leven patients are alive and in good cardiovascular conditions. After 6 months follow-up 4 patients out of 10 needed drug treatment for syst emic hypertension. At six months 2D echo examination, the two patients alive with preoperative cor pulmonale had a reduction in right ventri cular dimension and a complete recovery in systolic function.