Hemodynamic Follow-Up in Adult Patients with Pulmonary Hypertension Associated with Atrial Septal Defect after Partial Closure.
10.3349/ymj.2016.57.2.306
- Author:
Jinyoung SONG
1
;
June HUH
;
Sang Yun LEE
;
I Seok KANG
;
Chang Ha LEE
;
Cheul LEE
;
Ji Hyuk YANG
;
Tae Gook JUN
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. herzhuh@skku.edu
- Publication Type:Evaluation Studies ; Original Article
- Keywords:
Atrial septal defect;
pulmonary hypertension;
partial closure;
pulmonary vascular resistance index
- MeSH:
Adult;
Aged;
Cardiac Catheterization/*adverse effects;
Female;
Follow-Up Studies;
Heart Defects, Congenital/epidemiology/*physiopathology/*surgery;
Heart Septal Defects, Atrial/surgery;
Hemodynamics/*physiology;
Humans;
Hypertension, Pulmonary/diagnosis/epidemiology/*physiopathology;
Male;
Middle Aged;
Oxygen;
Postoperative Complications/diagnosis/epidemiology/*physiopathology;
Retrospective Studies;
Treatment Outcome;
Young Adult
- From:Yonsei Medical Journal
2016;57(2):306-312
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated the hemodynamic statuses of patients after partial closure of atrial septal defects with fenestration due to pulmonary hypertension. MATERIALS AND METHODS: Seventeen adult patients underwent partial atrial septal defect closure and follow-up cardiac catheterization. We analyzed hemodynamic data and clinical parameters before and after closure. RESULTS: The median age at closure was 29 years old. The baseline Qp/Qs was 1.9+/-0.6. The median interval from the operation to the cardiac catheterization was 27 months. The CT ratio decreased from 0.55+/-0.07 to 0.48+/-0.06 (p<0.05). The mean pulmonary arterial pressure decreased from 50.0+/-11.5 mm Hg to 32.5+/-14.4 mm Hg (p<0.05), and the pulmonary resistance index decreased from 9.2+/-3.6 Wood units*m2 to 6.3+/-3.8 Wood units*m2 (p<0.05). Eleven patients (64.7%) continued to exhibit high pulmonary resistance (over 3.0 Wood units*m2) after closure. These patients had significantly higher pulmonary resistance indices and mean pulmonary arterial pressures based on oxygen testing before the partial closures (p<0.05). However, no significant predictors of post-closure pulmonary hypertension were identified. CONCLUSION: Despite improvement in symptoms and hemodynamics after partial closure of an atrial septal defect, pulmonary hypertension should be monitored carefully.
