Hemodynamic Follow-Up in Adult Patients with Pulmonary Hypertension Associated with Atrial Septal Defect after Partial Closure.

Abstract:

PURPOSE:We evaluated the hemodynamic statuses of patients after partial closure of atrial septal defects with fenestration due to pulmonary hypertension. MATERIALS AND METHODS:Seventeen adult patients underwent partial atrial septal defect closure and follow-up cardiac catheterization. We analyzed hemodynamic data and clinical parameters before and after closure. RESULTS:The median age at closure was 29 years old. The baseline Qp/Qs was 1.9 ± 0.6. The median interval from the operation to the cardiac catheterization was 27 months. The CT ratio decreased from 0.55 ± 0.07 to 0.48 ± 0.06 (p<0.05). The mean pulmonary arterial pressure decreased from 50.0 ± 11.5 mm Hg to 32.5 ± 14.4 mm Hg (p<0.05), and the pulmonary resistance index decreased from 9.2 ± 3.6 Wood units*m² to 6.3 ± 3.8 Wood units*m² (p<0.05). Eleven patients (64.7%) continued to exhibit high pulmonary resistance (over 3.0 Wood units*m²) after closure. These patients had significantly higher pulmonary resistance indices and mean pulmonary arterial pressures based on oxygen testing before the partial closures (p<0.05). However, no significant predictors of post-closure pulmonary hypertension were identified. CONCLUSION:Despite improvement in symptoms and hemodynamics after partial closure of an atrial septal defect, pulmonary hypertension should be monitored carefully.

journal_name

Yonsei Med J

journal_title

Yonsei medical journal

authors

Song J,Huh J,Lee SY,Kang IS,Lee CH,Lee C,Yang JH,Jun TG

doi

10.3349/ymj.2016.57.2.306

subject

Has Abstract

pub_date

2016-03-01 00:00:00

pages

306-12

issue

2

eissn

0513-5796

issn

1976-2437

pii

57.306

journal_volume

57

pub_type

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