Incidence of pulmonary vein complications after lung transplantation

A prospective transesophageal echocardiographic study

David W. Leibowitz, Craig R. Smith, Robert E. Michler, Mark Ginsburg, Lawrence L. Schulman, Carlton C. McGregor, Giuseppe Li Mandri, Renee G. Weslow, Marco R. Di Tullio, Shunichi Homma

Research output: Contribution to journalArticle

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Abstract

Objectives. This study attempted to document the incidence of pulmonary vein complications and their potential relation to clinical outcome in patients after lung transplantation. Background. Several case reports have documented the presence of pulmonary venous thrombosis causing graft failure in patients after lung transplantation. Because the presentation of these complications mimics that of other postoperative problems, the true incidence of pulmonary vein abnormalities remains unclear. Transesophageal echocardiography is ideally suited to examine the pulmonary veins in the postoperative setting. Methods. Twenty-one consecutive patients undergoing lung transplantation at our institution underwent transesophageal echocardiography within 32 days of transplantation (mean [± SD] 6.5 ± 7.8 days). Special attention was placed on visualizing the pulmonary veins. Results. Six (29%) of the 21 patients were noted to have abnormalities of the pulmonary veins in the vicinity of the anastomotic site. After follow-up of 30 days, 4 of these patients (67%) had significant cardiovascular morbidity, and 2 died, compared with 1 (7%) of 15 patients with normal pulmonary veins (p = 0.03). The degree of obstruction of the pulmonary vein appeared to correlate with short-term outcome. Conclusions. Abnormalities of the pulmonary veins are common after lung transplantation and are easily identified by transesophageal echocardiography. Occlusive thrombi appear to be detrimental to short-term outcome.

Original languageEnglish (US)
Pages (from-to)671-675
Number of pages5
JournalJournal of the American College of Cardiology
Volume24
Issue number3
DOIs
StatePublished - 1994
Externally publishedYes

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Lung Transplantation
Pulmonary Veins
Incidence
Transesophageal Echocardiography
Venous Thrombosis
Thrombosis
Transplantation
Morbidity
Transplants
Lung

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Incidence of pulmonary vein complications after lung transplantation : A prospective transesophageal echocardiographic study. / Leibowitz, David W.; Smith, Craig R.; Michler, Robert E.; Ginsburg, Mark; Schulman, Lawrence L.; McGregor, Carlton C.; Mandri, Giuseppe Li; Weslow, Renee G.; Di Tullio, Marco R.; Homma, Shunichi.

In: Journal of the American College of Cardiology, Vol. 24, No. 3, 1994, p. 671-675.

Research output: Contribution to journalArticle

Leibowitz, DW, Smith, CR, Michler, RE, Ginsburg, M, Schulman, LL, McGregor, CC, Mandri, GL, Weslow, RG, Di Tullio, MR & Homma, S 1994, 'Incidence of pulmonary vein complications after lung transplantation: A prospective transesophageal echocardiographic study', Journal of the American College of Cardiology, vol. 24, no. 3, pp. 671-675. https://doi.org/10.1016/0735-1097(94)90013-2
Leibowitz, David W. ; Smith, Craig R. ; Michler, Robert E. ; Ginsburg, Mark ; Schulman, Lawrence L. ; McGregor, Carlton C. ; Mandri, Giuseppe Li ; Weslow, Renee G. ; Di Tullio, Marco R. ; Homma, Shunichi. / Incidence of pulmonary vein complications after lung transplantation : A prospective transesophageal echocardiographic study. In: Journal of the American College of Cardiology. 1994 ; Vol. 24, No. 3. pp. 671-675.
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abstract = "Objectives. This study attempted to document the incidence of pulmonary vein complications and their potential relation to clinical outcome in patients after lung transplantation. Background. Several case reports have documented the presence of pulmonary venous thrombosis causing graft failure in patients after lung transplantation. Because the presentation of these complications mimics that of other postoperative problems, the true incidence of pulmonary vein abnormalities remains unclear. Transesophageal echocardiography is ideally suited to examine the pulmonary veins in the postoperative setting. Methods. Twenty-one consecutive patients undergoing lung transplantation at our institution underwent transesophageal echocardiography within 32 days of transplantation (mean [± SD] 6.5 ± 7.8 days). Special attention was placed on visualizing the pulmonary veins. Results. Six (29{\%}) of the 21 patients were noted to have abnormalities of the pulmonary veins in the vicinity of the anastomotic site. After follow-up of 30 days, 4 of these patients (67{\%}) had significant cardiovascular morbidity, and 2 died, compared with 1 (7{\%}) of 15 patients with normal pulmonary veins (p = 0.03). The degree of obstruction of the pulmonary vein appeared to correlate with short-term outcome. Conclusions. Abnormalities of the pulmonary veins are common after lung transplantation and are easily identified by transesophageal echocardiography. Occlusive thrombi appear to be detrimental to short-term outcome.",
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AU - Schulman, Lawrence L.

AU - McGregor, Carlton C.

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AU - Homma, Shunichi

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N2 - Objectives. This study attempted to document the incidence of pulmonary vein complications and their potential relation to clinical outcome in patients after lung transplantation. Background. Several case reports have documented the presence of pulmonary venous thrombosis causing graft failure in patients after lung transplantation. Because the presentation of these complications mimics that of other postoperative problems, the true incidence of pulmonary vein abnormalities remains unclear. Transesophageal echocardiography is ideally suited to examine the pulmonary veins in the postoperative setting. Methods. Twenty-one consecutive patients undergoing lung transplantation at our institution underwent transesophageal echocardiography within 32 days of transplantation (mean [± SD] 6.5 ± 7.8 days). Special attention was placed on visualizing the pulmonary veins. Results. Six (29%) of the 21 patients were noted to have abnormalities of the pulmonary veins in the vicinity of the anastomotic site. After follow-up of 30 days, 4 of these patients (67%) had significant cardiovascular morbidity, and 2 died, compared with 1 (7%) of 15 patients with normal pulmonary veins (p = 0.03). The degree of obstruction of the pulmonary vein appeared to correlate with short-term outcome. Conclusions. Abnormalities of the pulmonary veins are common after lung transplantation and are easily identified by transesophageal echocardiography. Occlusive thrombi appear to be detrimental to short-term outcome.

AB - Objectives. This study attempted to document the incidence of pulmonary vein complications and their potential relation to clinical outcome in patients after lung transplantation. Background. Several case reports have documented the presence of pulmonary venous thrombosis causing graft failure in patients after lung transplantation. Because the presentation of these complications mimics that of other postoperative problems, the true incidence of pulmonary vein abnormalities remains unclear. Transesophageal echocardiography is ideally suited to examine the pulmonary veins in the postoperative setting. Methods. Twenty-one consecutive patients undergoing lung transplantation at our institution underwent transesophageal echocardiography within 32 days of transplantation (mean [± SD] 6.5 ± 7.8 days). Special attention was placed on visualizing the pulmonary veins. Results. Six (29%) of the 21 patients were noted to have abnormalities of the pulmonary veins in the vicinity of the anastomotic site. After follow-up of 30 days, 4 of these patients (67%) had significant cardiovascular morbidity, and 2 died, compared with 1 (7%) of 15 patients with normal pulmonary veins (p = 0.03). The degree of obstruction of the pulmonary vein appeared to correlate with short-term outcome. Conclusions. Abnormalities of the pulmonary veins are common after lung transplantation and are easily identified by transesophageal echocardiography. Occlusive thrombi appear to be detrimental to short-term outcome.

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