Follow up study on patients with pulmonary arterial hypertension after CHD repair / 中华胸心血管外科杂志

ABSTRACT

Objective To explore the long-term prognosis of the patientswithpulmonary arterial hypertension ( PAH) after cardiac repair operations through follow up .Methods We filtered the CHD patients with PAH after cardiac repair operation , admitted to the department of pediatric cardiology in Beijing Anzhen Hospital from June 2004 to December 2014, and collected their preoperative and postoperative data to analysis the long-term prognosis.Results 92 patients were included, median age was 20.78 years(2.44-60.26 years),median operation age was 13.54 years(1.33-53.99 years), World Health Organiza-tion functional classⅠ-Ⅱ was 80(86.96%), Ⅲ -Ⅳ was 12(13.04%), mean 6 min walk test distance was(481.74 ± 80.74) meters, mean Borg score was 1.53 ±1.14, and mean percutaneous oxygen saturation was 0.95 ±0.05.Among them, 64 patients completed preoperative right heart catheterization.Their average pulmonary artery pressure was(72.23 ±12.83) mmHg, aortic pressure on average was(85.57 ±11.91) mmHg, and average pulmonary vascular resistancewas(10.79 ±5. 04) Wood· U.The range of follow-up was between 6 months and 28.32 years(median 13.67years).During the follow-up, there were arrhythmia in 2 cases(2.17%), syncope in 7 cases(7.61%), hemoptysis in 4 cases(4.35%),heart failure in 8 cases(8.70%) and death in 1 case(1.09%).Compared with preoperative data, WHO cardiac function was found decreased in 22 patients(23.91%), stabled in 61 patients(66.30%) and significantly improved in 9 patients (9.78%).63 patients (68.48%) received targeted drug therapy, only 5 patients were treated with combined therapy,29 cases were not.Conclusion Compared with idiopathic pulmonary hypertension , PAH after defect correction has a lower incidence of arrhythmia , hemop-tysis and heart failure, and a higher long-term survival rate, and heart function is stable.To patients with PAH after defect cor-rection, targeted therapy is not only in perioperative period, but also more important in the long-term after surgery.In the targe-ted drug therapy, the combination treatment rate is low.