[Heart-lung transplantation. Initial clinical experience].

PURPOSE: To assess this initial clinical experience with heart-lung transplantation in Brazil.

METHODS

Four patients underwent heart-lung transplantation from December 1988 to March 1990, one patient with cardiomyopathy and high pulmonary resistance, two patients with primary pulmonary hypertension and another with pulmonary silicosis. The heart lung blocks were harvested from the donor using cardiopulmonary bypass and deep hypothermia. They were transplanted to the recipient by anastomosing the tracheae, right atrium or venae cavae, and the ascending aorta.

RESULTS

The second patient died on the 5th postoperative day due to respiratory insufficiency with consequent brain lesions. The first and third patients had survived nine months and 42 days respectively. The 4th patients is asymptomatic eight months after the operation. The main complications were bleeding in two patients, acute pulmonary rejection in three of them and obliterans bronchiolitis in one patients.

CONCLUSION

The heart lung transplantation is a challenging procedure which results are progressively improving with the development of better surgical technique and clinical concepts.