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.