|
Pulmonary Hypertension Treatment
Some pulmonary hypertension patients do well by taking medicines
that make the work of the right ventricle easier. Anticoagulants,
for example, can decrease the tendency of the blood to clot,
thereby permitting blood to flow more freely. Diuretics decrease
the amount of fluid in the body, further reducing the amount
of work the heart has to do.
Until recently, nothing more could be done for treatment
of pulmonary hypertension. However, today doctors can choose
from a variety of drugs that help lower blood pressure in
the lungs and improve the performance of the heart in many
patients.
Some patients also require supplemental oxygen delivered
through nasal prongs or a mask if breathing becomes difficult;
some need oxygen around the clock. In severely affected cases
of pulmonary hypertension, a heart-lung, single lung, or double
lung transplantation may be appropriate.
Drug Treatment
Doctors now know that pulmonary hypertension patients respond
differently to the different treatments that dilate, or relax,
blood vessels and that no one drug is consistently effective
in all patients. Because individual reactions vary, different
drugs have to be tried before chronic or long-term pulmonary
hypertension treatment begins. During the course of the disease,
the amount and type of medicine may also have to be changed.
Transplant Treatment
The first heart-lung transplant was performed in this country
in 1981. Many of these operations were performed for patients
with PPH. The survival rate is the same as for other patients
with heart-lung transplants, about 60 percent for 1 year,
and 37 percent for 5 years.
The single lung transplant is the most common method of transplant
used in cases of PPH. This procedure, in which one lung--either
the left or right--is replaced, was first performed in 1983
in patients with pulmonary fibrosis. Double lung transplants
are also done to treat PPH, but are less common than the single
lung transplant for treatment of PPH.
There are fewer complications with the single lung transplant
than with the heart-lung transplant, and the survival rate
is on the order of 70 percent for 1 year. A surprising finding
is the remarkable ability of the right ventricle to heal itself.
In patients with lung transplants, both the structure and
function of the right ventricle markedly improve. Complications
of transplantation include rejection by the body of the transplanted
organ, and infection. Patients take medications for life to
reduce their body's immune system's ability to reject "foreign"
organs.
|
