Acute pulmonary embolism in pediatric patients awaiting heart transplantation

Daphne T. Hsu, Linda J. Addonizio, Allan J. Hordof, Welton M. Gersony

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Acute pulmonary embolism with infarction can delay urgently needed heart transplantation and increase the postoperative pulmonary complications. Few data are available concerning pulmonary embolization in the pediatric patient with end-stage congestive heart failure. Sixty-two consecutive pediatric patients awaiting heart transplantation were monitored for evidence of acute pulmonary embolism. Acute pulmonary infarction was documented by ventilation-perfusion scan, pulmonary angiography or pathologic examination in six patients. The prevalence differed by diagnosis; 5 of 36 patients with dilated cardiomyopathy and 1 of 20 patients with congenital heart disease developed acute pulmonary embolism with infarction. No significant difference in age at the time of transplantation evaluation, duration of congestive heart failure, presence of cardiac arrhythmias or degree of cardiac dysfunction was seen between patients with and without pulmonary embolism. Two-dimensional echocardiography failed to detect the presence of an intracardiac thrombus in four of the six patients. Two patients who developed acute pulmonary infarction are alive after successful heart transplantation. The remaining four patients died within 6 weeks of initiation of anticoagulant therapy before transplantation could safely be performed. In summary, pediatric patients with end-stage congestive heart failure are at risk for acute pulmonary embolism. No specific clinical factor identified those patients who developed acute pulmonary infarction. Anticoagulant therapy is strongly recommended in the pediatric patient with poor ventricular function awaiting heart transplantation.

Original languageEnglish (US)
Pages (from-to)1621-1625
Number of pages5
JournalJournal of the American College of Cardiology
Volume17
Issue number7
DOIs
StatePublished - 1991
Externally publishedYes

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Heart Transplantation
Pulmonary Embolism
Pediatrics
Pulmonary Infarction
Heart Failure
Lung
Anticoagulants
Infarction
Transplantation
Ventricular Function
Dilated Cardiomyopathy
Ventilation
Echocardiography
Cardiac Arrhythmias
Heart Diseases
Angiography
Thrombosis
Perfusion

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Acute pulmonary embolism in pediatric patients awaiting heart transplantation. / Hsu, Daphne T.; Addonizio, Linda J.; Hordof, Allan J.; Gersony, Welton M.

In: Journal of the American College of Cardiology, Vol. 17, No. 7, 1991, p. 1621-1625.

Research output: Contribution to journalArticle

Hsu, Daphne T. ; Addonizio, Linda J. ; Hordof, Allan J. ; Gersony, Welton M. / Acute pulmonary embolism in pediatric patients awaiting heart transplantation. In: Journal of the American College of Cardiology. 1991 ; Vol. 17, No. 7. pp. 1621-1625.
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