Wireless pulmonary artery sensor implantation in a unilateral lung transplant recipient

Authors

Ryan Kelly, Department of Medicine, Yale-New Haven Health Greenwich Hospital, Greenwich, CT, USA.
Ju Young Bae, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale New Haven Health Bridgeport Hospital, Bridgeport, CT, USA.Follow
Ali Y. Mansour, Section of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Sameer Nagpal, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Samuel Hahn, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Karthik Murugiah, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.

Document Type

Article

Publication Title

Journal of cardiology cases

Abstract

UNLABELLED: Patients with lung transplantation can have concomitant left ventricular failure which can either precede the lung transplantation or develop after. Implantable wireless pulmonary artery (PA) pressure monitors to guide hemodynamic management in heart failure such as the CardioMEMS device (Abbott, Sylmar, CA, USA) have been shown to improve outcomes. However, in a lung transplant recipient there are unique physiological and practical considerations when contemplating to implant a PA pressure sensor such as safety of implanting the device, choice of site of implantation, accuracy of wedge tracings to calibrate, and exclusion of vascular stenoses post transplantation. We discuss these considerations in the context of a man in his early 60s with a known left lung transplant two years previously who developed worsening heart failure needing invasive monitoring. Right lung PA sensor placement was considered, but on selective pulmonary angiography the right PA was found to be of small caliber and with significant tortuosity. After careful hemodynamic assessment, the PA sensor was implanted in the PA of the transplanted lung which is the first such case to our knowledge. LEARNING OBJECTIVE: We report the first documented case of an implantable wireless pulmonary artery pressure monitor (CardioMEMs) into a transplanted lung. Device-related complications, such as pulmonary artery injury, infection, and hemoptysis, must be assessed after placement. Given the changes in pulmonary artery pressures after lung transplantation, recalibration of the CardioMEMs device may need to be considered if placed within first year of transplant.

First Page

216

Last Page

220

DOI

10.1016/j.jccase.2023.08.004

Publication Date

11-1-2023

Recommended Citation

Kelly, Ryan; Bae, Ju Young; Mansour, Ali Y.; Nagpal, Sameer; Hahn, Samuel; and Murugiah, Karthik, "Wireless pulmonary artery sensor implantation in a unilateral lung transplant recipient" (2023). Cardiology. 87.
https://scholar.bridgeporthospital.org/cardiology/87

Identifier

38024115 (pubmed); PMC10658300 (pmc); 10.1016/j.jccase.2023.08.004 (doi); S1878-5409(23)00094-4 (pii)