0104
POSTOPERATIVE HEMODYNAMIC PARAMETER
FOLLOW UP IN CHILDREN WITH SEVERE PULMONARY HYPERTENSION DUE TO VENTRICULAR
SEPTAL DEFECT Zhu
WH, Li JH, Zhu XK, Kang ML Children's
Hospital, Affiliated Medical College of Zhejiang University, Hangzhou,
China Objective: To study the relationship between age at operation and prognosis in
children with severe pulmonary hypertension (PH) due to ventricular septal
defect (VSD). Method: 20 children with severe PH (total pulmonary circulation
resistance increased) due to VSD were divided into two groups based on the
age at operation. Group I was age less than 3 and group II age large than
3. The ratio of pulmonary arterial pressure and systemic arterial pressure
(Pp/Ps), pulmonary resistance and systemic resistance (Rp/Rs), pulmonary
vascular resistance (PVR), percutaneous saturation (SaO2 ) and small
pulmonary arterial resistance (PAR) were measured at presurgery, one week
after surgery and 5 to 10 years postoperatively. Results: There were no differences in Pp/Ps, Rp/Rs, PVR, SaO2 and PAR
presurgery between group I and group II (P>0.05). But there were
significant differences in. Pp/Ps, Rp/Rs, PVR and PAR one week and 5 to 10
years after operation (p<0.01). In group I one week after surgery
Pp/Ps0.34±0.03,
Rp/Rs 0.23±0.04,
PVR31.32±9.53Kpa/(L·S) and PAR25.84±7.52 Kpa/(L·S) ,
5 to 10 years Pp/Ps0.25±0.02,
Rp/Rs0.18±0.04
, PVR21.05±4.86
Kpa/(L·S)
and PAR15.92±4.32
Kpa/(L·S).
In group II one week after surgery Pp/Ps0.52±0.17, Rp/Rs0.40±0.15,
PVR50.70±18.43
Kpa/(L·S)
and PAR41.16±18.64
Kpa/(L·S) .
5 to 10 years Pp/Ps0.33±0.08,
Rp/Rs0.24±0.05,
PVR 43.65±29.99
Kpa/(L·S)
and PAR36.56±27.12
Kpa/ (L·S).
During follow up in group I all the hemodynamic parameter were at normal
level, while in group II only Pp/Ps was close to normal level. The three
other hemodynamic parameteres were still abnormal. Conclusion: It indicated that early operation be the only way to gain optimal long
term result of surgery and decrease the incidence of pulmonary vascular
disease in children with PH due to VSD.