Anesthesia, Heart Transplant Failure
Conditions
Brief summary
Following orthoptopic heart transplantation (OHT), children undergo surveillance cardiac catheterizations to assess for signs of rejection including muscle biopsy as well as pressure measurements to guide post transplant treatment regiments. These procedures are done under general anesthesia which promotes lung tissue collapse (atelectasis). What is not known is the effect of atelectasis on intracardiac pressures which are a critical area of monitoring post-transplant patients for rejection.
Detailed description
Following orthoptopic heart transplantation (OHT), children undergo surveillance cardiac catheterizations to assess for signs of rejection including muscle biopsy as well as pressure measurements. These procedures are done under general anesthesia which promotes lung tissue collapse (atelectasis). Atalectaisis is known to alter intra-thoracic pressures and cardiac loading conditions. What is not known is the effect of atelectasis on intracardiac pressures which are a critical area of monitoring post-transplant patients for rejection. Therefore, the aim of this study is to identify if atelectasis impacts the pressure measurements obtained during cardiac catheterization.
Interventions
OTHERLung Recruitment
Lung Recruitment will be performed during general anesthesia to reduce areas of atelectasis
Sponsors
Baylor College of Medicine
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients having undergone orthotropic heart transplantation * Patients requiring routine heart catheterization for post-transplant surveillance * General anesthesia
Exclusion criteria
* Patient/parental refusal * Patients with suspected or known acute rejection * Known anti-rejection medication non-compliance * Patients within 1 year following heart transplant * Home oxygen requirement * Previous lung surgery (e.g., lobectomy) other than biopsy * Lung transplantation * Known pulmonary fibrosis * Known pulmonary hypertension (\>1/2 systemic) * Sedation without the use of an airway device * Active respiratory infection -Inability to provide recruitment breaths \>25mmHg -Cardiomegaly * Recipient/donor size mismatch
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with reduction of right ventricular end diastolic pressure of 3mmHg or greater | 10 minutes | Change of the right ventricular end diastolic pressure from pre and post recruitment breaths |
Countries
United States
Contacts
Primary ContactAdam Adler, MD
Outcome results
None listed