Impact of Atelectasis on RVEDP Following Orthotropic Heart Transplantation

Baylor College of Medicine

Status: Enrolling

Conditions: Heart Transplant Failure; Anesthesia

Treatments: Other: Lung Recruitment

Study type: Observational

Funder types: Other

Identifiers

NCT06140810

H52547

Details and patient eligibility

About

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.

Full 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.

Enrollment: 15 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

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

Trial design

15 participants in 1 patient group

Right ventricular End diastolic pressure

Description:

Measurement of pre and post recruitment right ventricular end diastolic pressure

Treatment:

Other: Lung Recruitment