Preoperative pulmonary hypertension ascertained by right heart catheterization in the lung transplantation (LT) recipient is associated with increased morbidity including supraventricular arrhythmias, especially in patients with pulmonary vascular disease. The prognostic significance of pre-LT tricuspid regurgitation (TR) ascertained by doppler echocardiography regarding postoperative supraventricular arrhythmias has not been described. We sought to evaluate the existance of any relationship between pre-LT TR and the occurence of postoperative supraventricular arrhythmias in LT recipients.
Of 154 total adult recipients who underwent LT between December 1990 and December 2001, 129 (84%) recipients had pre-operative Doppler echocardiograms performed. Their database was reviewed. Post-operative supraventricular arrhythmias were defined as any symptomatic or hemodynamically significant non-sinus tachycardia occurring in the first 30 days after LT. TR was defined as any evidence (mild, moderate or severe TR) of TR as ascertained by Doppler echocardiography.
Ninety-one (71%) LT recipients had pre-LT TR. There were no significant differences between groups (TR versus non-TR) regarding gender, race, type of transplant (single versus bilateral) or diagnosis (COPD (35%), cystic fibrosis (37%), IPF (23%), other (5%)). Mean age (years) was 49 ± 10 in the TR group verses 39 ± 9 (p=0.049) in the non-TR group. There were more supraventricular arrhythmias in the TR group (16 (76%) versus 5 (24%) (p=0.04)) as compared to the non-TR group.CONCLUSIONS: TR is common in patients undergoing LT. TR is seen more frequently in older LT recipients. TR is associated with more supraventricular arrhythmias.
Post-LT arrhythmias should be anticipated in patients with pre-LT TR. The effect of pre-LT TR on outcomes must be ascertained.
L.M. Arcement, None.