Study on lung biopsy in patients with severe pulmonary hypertension secondary to congenital heart disease / 重庆医学

ABSTRACT

Objective To investigate the nature of the pulmonary arterioles in the patients with severe pulmonary hypertension secondary to congenital heart disease .Methods All patients with congenital heart disease and secondary severe pulmonary hyper‐tension(PH) were selected by using diagnostic‐treatment to undergo the radical repair(n= 49) .The lung biopsy specimens were ob‐tained during operation .The nature of pulmonary vascular disease (PVD) was determined by Heath‐Edwards classification system . All specimens were quantitatively analyzed by calculating the arteriole medial area percentage ,medial thickness percentage and arte‐riole density .Results The transcutaneous oxygen saturation in all selected patients was increased significantly after diagnostic‐treatment(P< 0 .01) .There was no case of operative death .The postoperative mean pulmonary artery pressure and pulmonary vas‐cular resistance were decreased significantly (P < 0 .01) .38 cases (77 .6% ) showed the H‐E grade Ⅰ change ,5 cases (10 .2% ) showed the H‐E grade Ⅱ change ,4 cases(8 .2% ) showed the H‐E grade Ⅲ chfange and only 2 cases (4% ) showed the H‐E gradeⅣ change with plexiform lesion .Conclusion The pulmonary vessels in the selected patients with severe PH secondary to congenital heart disease by using the diagnostic‐treatment are generally reversible and still feasible for performing the radical operation .