Pulmonary hypertension in pediatric heart transplantation

Pulmonary hypertension can pose a significant problem in the management of children with congestive heart failure. Assessment of pulmonary artery anat omy, pressures and (when possible) pulmonary vascular resistance is critica lly important in the evaluation of these children when they are under consi deration for heart transplantation. Severe, fixed elevation of the pulmonar y vascular resistance is a contraindication to heart transplantation becaus e of concerns of acute post-transplant donor right ventricular failure. How ever, even modest degrees of pulmonary hypertension can complicate the post -operative management of pediatric heart transplant recipients. This review will provide information regarding the recognition, diagnosis, and pre-ope rative and post-operative management of pulmonary hypertension in patients under consideration for heart transplantation. (C) 2000 Elsevier Science Ir eland Ltd. All rights reserved.