Alina Cornea

By Alina Ligia Cornea, Claudiu E. Nistor, Diana Parau and Alexandru Mihai Cornea

Pulmonary hypertension (PH) is a medical condition with complex physiopathology due to several diseases involving heart, lung, connective tissue, or multifactorial. This chapter analyzes the main surgical procedures used in PH, starting with lung transplantation, pulmonary endarterectomy for chronic thromboembolism, mechanical circulatory support, and right-to-left shunts as palliative procedures. The indications for surgery, donor organ procurement, and preservation techniques are also reviewed.

Part of the book: New Insights on Pulmonary Hypertension

By Alina Ligia Cornea, Seamus Linnane, Peter Riddell, Diana Parau and Alexandru Mihai Cornea

The role of lung transplantation is to provide survival and quality of life benefits to patients with advanced lung disease. In this chapter, focusing on chronic obstructive pulmonary disease (COPD), we provide a comprehensive discussion of key aspects involved in the assessment of recipient suitability for transplantation. We discuss key issues such as timing of referral, donor evaluation, and organ allocation. We provide a detailed evaluation of the technical aspects of transplant surgery, evaluating the relative merits of both single and bilateral lung transplantation. In addition, we highlight how the transplant field is addressing donor shortfall, with expansion of acceptable donor criteria and the use of ex vivo lung perfusion to improve donor evaluation. Finally, we examine post-operative morbidity and mortality, discussing both early and late surgical complications and the adverse effects of long-term immunosuppression.

Part of the book: Pulmonary Emphysema

By Alexandru Mihai Cornea, Guillermo Rodriguez and Alina Ligia Cornea

This chapter provides a comprehensive exploration of the primary indications for employing mechanical circulatory support and heart transplantation in the treatment of end-stage cardiomyopathy. It emphasizes the specific types of support, patient selection criteria, optimal timing for intervention, and the prevalent varieties of mechanical assistance devices currently utilized. The chapter delves into nuanced patient outcomes concerning both temporary and long-term support, while also offering a succinct overview of the evolving perspectives within this field. Heart transplantation serves as the ultimate resource for cardiomyopathy patients for whom conventional medical therapy has proven ineffective. This section centers on delineating the indications and contraindications for heart transplantation, emphasizing patient care protocols, early and late postoperative complications, and the future trajectories in this domain. A critical analysis scrutinizes and compares the efficacy and applicability of mechanical assistance against heart transplantation within this patient cohort. Given the intricacies of surgical interventions for cardiomyopathy, the chapter outlines prospects, encompassing advancements such as xenotransplantation and the integration of new mechanical assist devices into the evolving landscape of treatments.

Part of the book: Exploring the Causes, Prevention and Management of Cardiomyopathy [Working title]