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

Authors : Ali ORGUN, Niyazi TOKEL, İlkay ERDOĞAN, Birgül VARAN, Murat ÖZKAN, Mehmet Sait AŞLAMACI

Pages : 1131-1138

Doi:10.17826/cumj.1335119

View : 9 | Download : 31

Publication Date : 2023-09-30

Article Type : Research Paper

Abstract :Purpose: In this retrospective study, pediatric patients who underwent surgery for large ventricular septal defect insert ignore into journalissuearticles values(VSD); with severe pulmonary arterial hypertension insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(PVRI); and compared insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(median: 5 years);. PVRI ranged between 3 and 18.4 WU.m² insert ignore into journalissuearticles values(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, PVR/SVR, 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 insert ignore into journalissuearticles values(range, 1 month-18 years);. PAH was seen in 15/24 insert ignore into journalissuearticles values(62.5%); patients. Severe PAH was observed in seven of these 15 patients and all were in group 2 insert ignore into journalissuearticles values(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.
Keywords : Doğuştan kalp hastalığı, pulmoner arteriyal hipertansiyon, ventriküler septal defekt