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Updated: Aug 26, 2026

Structured Exercise Regimen in Pulmonary Hypertension-Right Ventricular Failure in an Ovine Model
Published on: May 5, 2026
Left ventricular unloading in a patient with end-stage cardiomyopathy and medically unresponsive pulmonary
Abdulaziz Al-Khaldi1, Patrick Ergina, Benoit DeVarennes
1Division of Cardiothoracic Surgery, McGill University Health Center, Montreal, Quebec, Canada.
Abstract:
Severe, medically unresponsive pulmonary hypertension (PHT) is considered to be a contraindication for orthotopic heart transplantation (OHT). Chronic left ventricular (LV) unloading using a left ventricular assist device (LVAD) might result in reversal of the elevated pulmonary vascular resistance (PVR), allowing successful OHT in such patients. In this study, we present a patient with end-stage ischemic cardiomyopathy and fixed, elevated PVR (7.1 Wood units) who underwent implantation of a Novacor LVAD (Baxter Healthcare Corp., Deerfield, IL, U.S.A.), with a subsequent reduction in PVR to 1.2 Wood units and successful OHT eleven months post-LVAD implantation. Three years after heart transplant, the patient still leads an active life with no right heart failure. In conclusion, OHT is not contraindicated in patients with end-stage heart failure and medically unresponsive PHT in the presence of elevated left atrial pressure. Left ventricular unloading should be considered in these patients to allow reversal of the elevated PVR before OHT.
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