Surgical outcomes and long-term follow-up of patients with large ventricular septal defects with severe pulmonary arterial hypertension: single-center experience

Ali Orgun; Niyazi Tokel; İlkay Erdoğan; Birgül Varan; Murat Özkan; Mehmet Sait Aşlamacı

Makale detayları

Surgical outcomes and long-term follow-up of patients with large ventricular septal defects with severe pulmonary arterial hypertension: single-center experience

Yazarlar:

Ali Orgun | Niyazi Tokel | İlkay Erdoğan | Birgül Varan | Murat Özkan | Mehmet Sait Aşlamacı

Yayıncı:

Cukurova University

Ana Başlıklar:

Kalp ve Damar Cerrahisi | Çocuk Kardiyolojisi

Dergi:

Cukurova Medical Journal Vol.48 Issue 3, pp.1131-1138

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286404

pISSN:

2602-3032

Anahtar kelimeler:

Özet:

 Purpose: In this retrospective study, pediatric patients who underwent surgery for large ventricular septal defect VSD with severe pulmonary arterial hypertension PAH were evaluated in detail in terms of clinical characteristics, and long-term results, and reinterpreted with the current surgical criteria. Materials and Methods: Twenty-four patients who underwent surgery for large VSD due to PAH between 1994 and 2005 were included in the study. The patients were divided into two groups according to their pulmonary vascular resistance index PVRI and compared group 1 with PVRI 6 WU.m² and group 2 with PVRI  6 WU.m². The patients with PVRI 6-8 WU.m² were accepted as being in the gray zone and were evaluated in detail. Results: Age at diagnosis ranged from 5 months to 17 years median: 5 years. PVRI ranged between 3 and 18.4 WU.m² median PVRI was 5 WU.m². According to the PVRI, 13 patients were accepted as group 1, and 11 patients were accepted as group 2. mPAP, PVRSVR, and last PAP values were found statistically significantly lower in group 1 than in group 2. The median postoperative follow-up time was 6 years range, 1 month-18 years. PAH was seen in 1524 62.5 patients. Severe PAH was observed in seven of these 15 patients and all were in group 2 four had PVRI 8WU.m² and three had PVRI 6-8 WU.m². Conclusion: Patients with large VSD with severe PAH should be carefully evaluated before surgery to more accurately identify suitable candidates.

 Purpose: In this retrospective study, pediatric patients who underwent surgery for large ventricular septal defect VSD with severe pulmonary arterial hypertension PAH were evaluated in detail in terms of clinical characteristics, and long-term results, and reinterpreted with the current surgical criteria. Materials and Methods: Twenty-four patients who underwent surgery for large VSD due to PAH between 1994 and 2005 were included in the study. The patients were divided into two groups according to their pulmonary vascular resistance index PVRI and compared group 1 with PVRI 6 WU.m² and group 2 with PVRI  6 WU.m². The patients with PVRI 6-8 WU.m² were accepted as being in the gray zone and were evaluated in detail. Results: Age at diagnosis ranged from 5 months to 17 years median: 5 years. PVRI ranged between 3 and 18.4 WU.m² median PVRI was 5 WU.m². According to the PVRI, 13 patients were accepted as group 1, and 11 patients were accepted as group 2. mPAP, PVRSVR, and last PAP values were found statistically significantly lower in group 1 than in group 2. The median postoperative follow-up time was 6 years range, 1 month-18 years. PAH was seen in 1524 62.5 patients. Severe PAH was observed in seven of these 15 patients and all were in group 2 four had PVRI 8WU.m² and three had PVRI 6-8 WU.m². Conclusion: Patients with large VSD with severe PAH should be carefully evaluated before surgery to more accurately identify suitable candidates.

 Purpose: In this retrospective study, pediatric patients who underwent surgery for large ventricular septal defect VSD with severe pulmonary arterial hypertension PAH were evaluated in detail in terms of clinical characteristics, and long-term results, and reinterpreted with the current surgical criteria. Materials and Methods: Twenty-four patients who underwent surgery for large VSD due to PAH between 1994 and 2005 were included in the study. The patients were divided into two groups according to their pulmonary vascular resistance index PVRI and compared group 1 with PVRI 6 WU.m² and group 2 with PVRI  6 WU.m². The patients with PVRI 6-8 WU.m² were accepted as being in the gray zone and were evaluated in detail. Results: Age at diagnosis ranged from 5 months to 17 years median: 5 years. PVRI ranged between 3 and 18.4 WU.m² median PVRI was 5 WU.m². According to the PVRI, 13 patients were accepted as group 1, and 11 patients were accepted as group 2. mPAP, PVRSVR, and last PAP values were found statistically significantly lower in group 1 than in group 2. The median postoperative follow-up time was 6 years range, 1 month-18 years. PAH was seen in 1524 62.5 patients. Severe PAH was observed in seven of these 15 patients and all were in group 2 four had PVRI 8WU.m² and three had PVRI 6-8 WU.m². Conclusion: Patients with large VSD with severe PAH should be carefully evaluated before surgery to more accurately identify suitable candidates.

 Amaç: Bu retrospektif çalışmada, şiddetli pulmoner arteryal hipertansiyonlu PAH geniş ventriküler septal defekt VSD nedeniyle ameliyat edilen pediatrik hastalar, klinik özellikleri ve uzun dönem sonuçları açısından ayrıntılı olarak değerlendirilmiş ve güncel ameliyat kriterleri ile yeniden yorumlanmıştır. Gereç ve Yöntem: 1994-2005 yılları arasında PAHlı geniş VSD nedeni ile ameliyat edilen ve takibi yapılan 24 çocuk hasta çalışmaya dahil edildi. Hastalar pulmoner vasküler resiztans indexinePVRI göre iki gruba ayrıldı ve karşılaştırıldı grup 1:PVRI 6 WU.m² olan olgular, grup 2: PVRI  6 WU.m² olan olgular. PVRI 6-8 WU.m² olan olgular gri bölgede kabul edildi ve detaylı olarak değerlendirildi. Bulgular: Tanı yaşı 5 ay ile 17 yıl medyan: 5 yıl arasındaydı. Ortanca PVRI 5 WU.m² olup 3 -18,4 WU.m² arasında değişmekteydi. PVRI ye göre 13 hasta grup 1, 11 hasta ise grup 2 olarak kabul edildi. Grup 1de grup 2ye göre istatistiksel olarak anlamlı olarak mPAP, PVRSVR ve son PAP değerleri düşük bulundu. Ameliyat sonrası ortanca takip süresi 6 yıl 1 ay-18 yıl olup takipte 15 hastada 62,5 PAH görüldü. Bu 15 hastanın 7sinde şiddetli PAH gözlenmiş olup bu 7 hastanın tamamı grup 2deydi dördünde PVRI 8WU.m² ve üçünde PVRI 6-8 WU.m². Sonuç: Şiddetli PAH gelişmiş geniş VSDsi olan hastalarda, ameliyat için uygun adayları daha doğru bir şekilde belirlemek için ameliyattan önce klinik ve özellikle hemodinamik durumları dikkatlice değerlendirilmelidir.

Makale detayları

Surgical outcomes and long-term follow-up of patients with large ventricular septal defects with severe pulmonary arterial hypertension: single-center experience

Yazarlar:

Ali Orgun | Niyazi Tokel | İlkay Erdoğan | Birgül Varan | Murat Özkan | Mehmet Sait Aşlamacı

Yayıncı:

Cukurova University

Ana Başlıklar:

Kalp ve Damar Cerrahisi | Çocuk Kardiyolojisi

Dergi:

Cukurova Medical Journal Vol.48 Issue 3, pp.1131-1138

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286404

pISSN:

2602-3032

Congenital heart disease

Pulmonary arterial hypertension

Ventricular septal defect

Doğuştan kalp hastalığı

pulmoner arteriyal hipertansiyon

ventriküler septal defekt

Sayı

Makale detayları

Surgical outcomes and long-term follow-up of patients with large ventricular septal defects with severe pulmonary arterial hypertension: single-center experience

Yazarlar: Ali Orgun | Niyazi Tokel | İlkay Erdoğan | Birgül Varan | Murat Özkan | Mehmet Sait Aşlamacı

Yayıncı: Cukurova University

Ana Başlıklar: Kalp ve Damar Cerrahisi | Çocuk Kardiyolojisi

Dergi: Cukurova Medical Journal Vol.48 Issue 3, pp.1131-1138

Belge Tipi: Makale

Yayın Tarihi: 9/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001286404

pISSN: 2602-3032

Congenital heart disease

Pulmonary arterial hypertension

Ventricular septal defect

Doğuştan kalp hastalığı

pulmoner arteriyal hipertansiyon

ventriküler septal defekt

Sayı

Yazarlar:

Ali Orgun | Niyazi Tokel | İlkay Erdoğan | Birgül Varan | Murat Özkan | Mehmet Sait Aşlamacı

Yayıncı:

Cukurova University

Ana Başlıklar:

Kalp ve Damar Cerrahisi | Çocuk Kardiyolojisi

Dergi:

Cukurova Medical Journal Vol.48 Issue 3, pp.1131-1138

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286404

pISSN:

2602-3032