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Updated: Jan 13, 2026

Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Prolonged intra-aortic balloon pump support successfully reversed severe pulmonary hypertension prior to heart
Zeng Xiaodong1, Wu Min2, Huang Jinsong2
1Department of Cardiac Surgery Intensive Care Unit, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Background:
Heart transplantation remains the gold standard for the treatment of end-stage heart failure, but severe pulmonary hypertension (PH) poses a significant challenge due to the increased risk of complications after surgery. International guidelines classify severe PH as a relative contraindication to transplantation, requiring meticulous preoperative management.
Case Presentation:
We present the case of a 58-year-old man with severe heart failure and PH who received intra-aortic balloon pump (IABP) support for 62 days. Through targeted medical therapy and meticulous fluid management, remarkable hemodynamic improvements were achieved, exceeding the threshold for surgical contraindication. This allowed for a successful heart transplantation. Postoperatively, the patient experienced transient hemodynamic instability, which was effectively managed with vasopressor therapy and inhaled nitric oxide. With continued perioperative management, the patient experienced a smooth recovery and achieved a favorable outcome.
Conclusion:
This case highlights the effectiveness of prolonged IABP assistance in reversing severe PH prior to transplantation, thereby facilitating successful heart transplantation. By implementing rigorous comprehensive perioperative management, patients with severe pulmonary hypertension can achieve positive outcomes after transplantation.

