Обратимая легочная гипертензия у пациентки после трансплантации почки с длительно функционирующей артериовенозной фистулой

Представлено описание клинического случая обратимой высокой легочной гипертензии (ЛГ) у пациентки с успешной трансплантацией почки (ТП), особенностью которого было функционирование артериовенозной фистулы (АВФ) с избыточным кровотоком в течение 15 лет при отсутствии показаний к проведению гемодиализа. ЛГ сопровождалась развитием тяжелой застойной сердечной недостаточности (ЗСН) с высоким сердечным выбросом. Лигирование АВФ привело к полному регрессу клинико-инструментальных и лабораторных признаков ЛГ и ЗСН в течение 2 недель. Обсуждается патогенетическая роль избыточного кровотока по АВФ в формировании ЛГ и ЗСН. Рекомендуется лигирование АВФ с избыточным кровотоком в случае формирования симптомной ЛГ у пациентов после успешной ТП.

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