Right Heart Recovery Post Lung Transplant With COVID‐19‐Related Acute Respiratory Distress Syndrome

Résumé fourni par la source

Background: Right heart remodeling is noted in patients with severe COVID‐19‐associated acute respiratory distress syndrome (ARDS). There is limited information regarding right heart recovery following lung transplantation in this cohort. Methods: Retrospective review of institutional transplant database from June 2020 to June 2022 was performed at Northwestern University in Chicago, Illinois. Demographic, laboratory, histopathologic, lung transplant outcomes, and pre‐ and postoperative echocardiographic data were recorded and analyzed. Results: Of the 42 patients who underwent lung transplantation for COVID‐19‐related ARDS, 6 patients were excluded due to having either a single‐lung transplant (n = 2), lobar transplant (n = 1), or dual‐organ transplant (n = 1) or for missing postoperative TTE data (n = 2) and 36 were included in the study; there were no 90‐day deaths, and the 1‐year survival rate was 88.8%. Intraoperative hemodynamics data showed a mean pulmonary artery pressure of 49 ± 23 mm Hg. Preoperative echocardiography was evaluated at a median of 15.5 (10–34.3) (IQR) days preoperatively and 140 (108–201) days (IQR) postoperatively. RV size grade improved from an average of 1.7 ± 0.85 to 1.3 ± 0.6 (p < 0.05), while RV function improved from an average of 2.2 ± 1.2 to 1 ± 1 (p < 0.05). There was a reduction in RVSP from 46.5 ± 18 mmHg to 30.1 ± 7.8 mmHg (p < 0.05) and RV free wall strain showed improvement from −13.9 ± 6.1% to −18.5 ± 5.4% (p < 0.05). Conclusions: The results showed that the RV size and systolic function demonstrate improvement with normalization in a relatively short period following lung transplantation for patients with COVID‐19‐associated ARDS.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.