A ten-year post-surgical assessment of pulmonary hypertension in adults with patent ductus arteriosus.

ABSTRACT

The long-term follow-up was analysed for 25 patients above the age of 12 years who had patent ductus arteriosus with severe pulmonary hypertension and had undergone surgical closure. There were 11 males and 14 females (age range 12-27 years; mean 18.6 years). There were 2 early and 2 late deaths. All the 21 survivors were followed up at regular intervals for 8-10 years. They were assessed by haemodynamic study 13 of the 21 survivors underwent a study 6 months to 1 year after surgery and another 4 patients, 8 years after surgery; 7 patients of the 13 had a second study 8-10 years after surgery. The pulmonary artery systolic and mean pressures regressed to 50% of the preoperative level in the first study for 15 patients, and in the second study 2 patients had further drop in pulmonary artery pressures; however, the pressure levels never reached normal values. The pulmonary vascular resistance did not show a correspondingly significant fall. In conclusion, the ten-year follow-up shows that the patients have benefited by the surgery though the pressures have not come down to normal levels, and that they have to be followed up closely to assess the natural history of residual pulmonary hypertension and pulmonary vascular disease and its effect on their quality of life.