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Prediction of Pulmonary Arterial Pressure Level after Repair of Congenital Cardiac Communications and Discharge from the Hospital: Role of Down Syndrome and Early Postoperative Hemodynamics

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Congenital Heart Disease 2022年第3期17卷 351-363页

作者： eloisa sassa carvalho Maria Francilene SSouza Kelly Cristina O.Abud Claudia R.P.Castro Juliano G.Penha Ana Maria Thomaz Vanessa A.Guimaraes Antonio Augusto Lopes Heart Institute(InCor) University of Sao Paulo School of MedicineSão PauloBrazil

Background:Postoperative pulmonary hypertension limits the success of surgical treatment in some patients with unrestrictive congenital cardiac *** patients at risk of developing postoperative pulmonary hypertension is important to individualize follow-up ***:We analyzed a prospective cohort of 52 pediatric patients(age 3 to 35 months)looking for perioperative predictors of mildly elevated pulmonary arterial pressure 6 months after surgery,defined as a systolic pressure greater than 30 mmHg by transthoracic *** corresponds to a mean pulmonary arterial pressure of>20 ***,echocardiographic and hemodynamic parameters were *** hemodynamics was assessed by directly measuring pulmonary and systemic arterial pressures using indwelling *** postoperative pulmonary hemodynamics was defined as the mean pulmonary/systemic mean arterial pressure ratio(PAP/SAP)obtained per patient during the first 6 h of postoperative ***:Among the factors that were investigated as possible predictors,perioperative hemodynamics and the presence of Down syndrome were initially selected using univariate analysis(p0.35 was 76%sensitive and 74%specific at predicting a systolic pulmonary arterial pressure of>30 mmHg 6 months after surgery(hazard ratio with 95%CI 8.972[2.428–33.158],p=0.002).Conclusion:The hypertensive early postoperative behavior of the pulmonary circulation was strongly but not exclusively associated with Down syndrome,and it was char

关键词： Pulmonary hypertension congenital heart disease Down syndrome pediatric cardiac surgery

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