Residual Pulmonary Hypertension more than 20 Years after Repair of Shunt Lesions
<i>Background and </i><i>O</i><i>bjectives:</i> After successful surgical repair of a congenital shunt lesion, pulmonary hypertension (PH) often disappears. However, PH can persist long-term after the closure. This study aimed to assess the prevalence of PH long-t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-06-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/56/6/297 |
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| author | Dovilė Jančauskaitė Virginija Rudienė Gabrielius Jakutis Laurie W Geenen Jolien W Roos-Hesselink Lina Gumbienė |
| author_facet | Dovilė Jančauskaitė Virginija Rudienė Gabrielius Jakutis Laurie W Geenen Jolien W Roos-Hesselink Lina Gumbienė |
| author_sort | Dovilė Jančauskaitė |
| collection | DOAJ |
| description | <i>Background and </i><i>O</i><i>bjectives:</i> After successful surgical repair of a congenital shunt lesion, pulmonary hypertension (PH) often disappears. However, PH can persist long-term after the closure. This study aimed to assess the prevalence of PH long-term after surgical repair of congenital heart disease (CHD), and to evaluate the outcomes and preoperative factors related to residual PH.<b> </b><i>Materials and Methods:</i> In this retrospective cohort study, we reviewed patients who underwent right heart catheterisation in Vilnius University Hospital Santaros Klinikos during the period of 1985–2007. Among 4118 right heart catheterisations performed, 160 patients underwent congenital systemic-to-pulmonary shunt repair at a young age (<18 years) and had pre-operative PH. Half of the patients were foreigners whose follow-up data were unavailable. Eventually, 88 patients with available follow-up data were included in this study. <i>Results:</i> The median age at diagnosis of CHD with PH was 0.8 (0.6–3.0) and 1.1 (0.6–3.9) years at surgery (50% females). Residual PH was assessed 9.5 years after surgery and observed in 30.7% (<i>n</i> = 27) of the patients. It was associated with having more than one shunt (44.4% (<i>n</i> = 12), <i>p</i> = 0.016) and higher median pulmonary vascular resistance (3.4 (2.5–6.5) vs. 2.2 (1.0–3.7), <i>p</i> = 0.035) at baseline. After a median follow-up of 21 (15–24) years, 9.1% of the patients were deceased. Kaplan–Meier survival analysis revealed significantly higher mortality in the residual PH group (<i>p</i> = 0.035). <i>Conclusions:</i> Residual PH affects a significant proportion of patients after surgical repair of a shunt lesion and is associated with worse long-term outcome. |
| first_indexed | 2024-03-12T11:13:52Z |
| format | Article |
| id | doaj.art-9fd3f13849364978bb754bde801d4633 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T11:13:52Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-9fd3f13849364978bb754bde801d46332023-09-02T02:28:06ZengMDPI AGMedicina1010-660X2020-06-015629729710.3390/medicina56060297Residual Pulmonary Hypertension more than 20 Years after Repair of Shunt LesionsDovilė Jančauskaitė0Virginija Rudienė1Gabrielius Jakutis2Laurie W Geenen3Jolien W Roos-Hesselink4Lina Gumbienė5Centre of Cardiology and Angiology, Vilnius University, LT 08661 Vilnius, LithuaniaFaculty of Medicine, Vilnius University, LT 03101 Vilnius, LithuaniaFaculty of Medicine, Vilnius University, LT 03101 Vilnius, LithuaniaDepartment of Cardiology, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsDepartment of Cardiology, Erasmus MC University Medical Center Rotterdam, 3000 CA Rotterdam, The NetherlandsCentre of Cardiology and Angiology, Vilnius University, LT 08661 Vilnius, Lithuania<i>Background and </i><i>O</i><i>bjectives:</i> After successful surgical repair of a congenital shunt lesion, pulmonary hypertension (PH) often disappears. However, PH can persist long-term after the closure. This study aimed to assess the prevalence of PH long-term after surgical repair of congenital heart disease (CHD), and to evaluate the outcomes and preoperative factors related to residual PH.<b> </b><i>Materials and Methods:</i> In this retrospective cohort study, we reviewed patients who underwent right heart catheterisation in Vilnius University Hospital Santaros Klinikos during the period of 1985–2007. Among 4118 right heart catheterisations performed, 160 patients underwent congenital systemic-to-pulmonary shunt repair at a young age (<18 years) and had pre-operative PH. Half of the patients were foreigners whose follow-up data were unavailable. Eventually, 88 patients with available follow-up data were included in this study. <i>Results:</i> The median age at diagnosis of CHD with PH was 0.8 (0.6–3.0) and 1.1 (0.6–3.9) years at surgery (50% females). Residual PH was assessed 9.5 years after surgery and observed in 30.7% (<i>n</i> = 27) of the patients. It was associated with having more than one shunt (44.4% (<i>n</i> = 12), <i>p</i> = 0.016) and higher median pulmonary vascular resistance (3.4 (2.5–6.5) vs. 2.2 (1.0–3.7), <i>p</i> = 0.035) at baseline. After a median follow-up of 21 (15–24) years, 9.1% of the patients were deceased. Kaplan–Meier survival analysis revealed significantly higher mortality in the residual PH group (<i>p</i> = 0.035). <i>Conclusions:</i> Residual PH affects a significant proportion of patients after surgical repair of a shunt lesion and is associated with worse long-term outcome.https://www.mdpi.com/1010-660X/56/6/297pulmonary hypertensioncongenital heart diseasesurgeryright heart catheterisation |
| spellingShingle | Dovilė Jančauskaitė Virginija Rudienė Gabrielius Jakutis Laurie W Geenen Jolien W Roos-Hesselink Lina Gumbienė Residual Pulmonary Hypertension more than 20 Years after Repair of Shunt Lesions Medicina pulmonary hypertension congenital heart disease surgery right heart catheterisation |
| title | Residual Pulmonary Hypertension more than 20 Years after Repair of Shunt Lesions |
| title_full | Residual Pulmonary Hypertension more than 20 Years after Repair of Shunt Lesions |
| title_fullStr | Residual Pulmonary Hypertension more than 20 Years after Repair of Shunt Lesions |
| title_full_unstemmed | Residual Pulmonary Hypertension more than 20 Years after Repair of Shunt Lesions |
| title_short | Residual Pulmonary Hypertension more than 20 Years after Repair of Shunt Lesions |
| title_sort | residual pulmonary hypertension more than 20 years after repair of shunt lesions |
| topic | pulmonary hypertension congenital heart disease surgery right heart catheterisation |
| url | https://www.mdpi.com/1010-660X/56/6/297 |
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