Effect of pulmonary arterial hypertension on early outcomes of children with functional single ventricle after Fontan operation: A case control study
10.7507/1007-4848.201709033
- VernacularTitle:肺动脉高压对功能性单心室患儿 Fontan 术后早期转归影响的病例对照研究
- Author:
ZHANG Mingjie
1
,
2
;
XU Zhuoming
1
,
2
;
HUANG Rui
1
,
2
;
SUN Chongrui
1
,
2
Author Information
1. Department of Cardiothoracic Surgery, Shanghai Children&rsquo
2. s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200127, P.R.China
- Publication Type:Journal Article
- Keywords:
Fontan operation;
pulmonary arterial hypertension;
early outcomes
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(2):123-127
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of pulmonary arterial hypertension on the children with functional single ventricle in the early period after Fontan operation. Methods Forty-three children with pulmonary arterial hypertension after Fontan operation were enrolled in our department between January 2015 and December 2016. There were 24 males and 19 females at a median age of 4.3 years ranging from 2.5 to 4.8 years. The pulmonary arterial pressure was evaluated by cardiac catheterization. There were 23 children diagnosed without pulmonary hypertension (a non-PAH group) including 16 males and 7 females, while 20 patients were diagnosed with pulmonary hypertension (a PAH group) including 8 males and 12 females. Postoperative parameters related to outcomes were compared between the two groups. Results There was no death in the non-PAH group, but the mortality of children in the PAH group was 20.0% (4/20， χ2=5.34, P=0.02). The central venous pressure (t=–2.50, P=0.02), N-terminal prohormone of brain natriuretic peptide (NT-proBNP, Z=–3.50, P<0.01), peritoneal dialysis rate (χ2=5.40, P=0.02), incidence of arrhythmia (χ2=4.40, P=0.03) in the PAH group were significantly higher than those of the non-PAH group. The early postoperative utilization rate of pulmonary vascular targeting agents in the PAH group was significantly higher than that in the non-PAH group (χ2=6.30, P=0.04). Conclusion Pulmonary arterial hypertension is one of the most important factors which influence the early postoperative prognosis of children with functional single ventricle after Fontan operation.
