Association of Preoperative Mixed Venous Oxygen Saturation with Postoperative Segmental Pulmonary Hypertension in Pulmonary Atresia with Ventricular Septal Defect and Major Aortopulmonary Collaterals
Association of Preoperative Mixed Venous Oxygen Saturation with Postoperative Segmental Pulmonary Hypertension in Pulmonary Atresia with Ventricular Septal Defect and Major Aortopulmonary Collaterals
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合并室间隔缺损和主肺动脉侧支的肺动脉闭锁患者术前混合静脉血氧饱和度与术后节段性肺动脉高压的关系
DOI：
10.1007/s00246-020-02428-6
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发表时间：
2020
影响因子：
1.6
通讯作者：
Kaneko Yukihiro
中科院分区：
文献类型：
--
作者：
Hayashi Taiyu;Ono Hiroshi;Kaneko Yukihiro
在伴有室间隔缺损和主肺主动脉侧支动脉（PA/VSD/MAPCA）的肺动脉闭锁患者中，节段性肺动脉高压常见；然而，其病理生理学仍有待阐明。本研究旨在确定 PA/VSD/MAPCA 患者心内修复术后与节段性肺动脉高压相关的术前血流动力学因素。这项研究包括 12 名 PA/VSD/MAPCA 患者，他们从 2009 年起在我们机构接受了单焦点治疗和心内修复术。收集术前和术后心导管插入术的血流动力学测量结果。如果术后在任何外周肺动脉测量的平均肺动脉压 ≥ 20 mmHg，则认为患者患有肺动脉高压。对有和无术后节段性肺动脉高压患者的数据进行比较；p值 < 0.05被认为有统计学意义。心内修复手术在 2.1 岁（范围 0.5-28.2 岁）时进行。两名患者在心内修复之前分别进行了单焦化，另外 10 名患者同时进行了单焦化。心内修复术后 1.2 年（范围 0.2-8.7 年）进行的术后心导管检查显示，5 名患者患有节段性肺动脉高压。术后肺动脉高压患者术前混合静脉氧饱和度显着低于无肺动脉高压患者（57% [55–63%] vs. 65% [53–75%]，p< 0.05）。各组之间在心内修复年龄、术前动脉氧饱和度和术前外周肺动脉平均压方面没有发现显着差异。 PA/VSD/MAPCA 患者术前混合静脉氧饱和度较低与心内修复术后节段性肺动脉高压相关。
In patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries (PA/VSD/MAPCAs), segmental pulmonary hypertension is common; however, its pathophysiology remains to be elucidated. This study aimed to identify preoperative hemodynamic factors associated with segmental pulmonary hypertension after intracardiac repair in patients with PA/VSD/MAPCAs. This study included 12 patients with PA/VSD/MAPCAs who underwent unifocalization and intracardiac repair from 2009 at our institution. Hemodynamic measurements of preoperative and postoperative cardiac catheterization were collected. Patients were considered to have pulmonary hypertension if the mean pulmonary pressure measured postoperatively at any peripheral pulmonary artery was ≥ 20 mmHg. The data were compared between patients with and without postoperative segmental pulmonary hypertension;pvalue < 0.05 was considered statistically significant. Intracardiac repair was performed at the age of 2.1 years (range 0.5–28.2 years). Unifocalization was performed separately prior to intracardiac repair in two patients and concomitantly in 10 patients. Postoperative cardiac catheterization, performed 1.2 years (range 0.2–8.7 years) after intracardiac repair, revealed that five patients had segmental pulmonary hypertension. Patients with postoperative pulmonary hypertension had significantly lower preoperative mixed venous oxygen saturation than those without pulmonary hypertension (57% [55–63%] vs. 65% [53–75%],p< 0.05). No significant differences were found between the groups in terms of age at intracardiac repair, preoperative arterial oxygen saturation, and preoperative peripheral pulmonary arterial mean pressure. Lower preoperative mixed venous oxygen saturation was associated with segmental pulmonary hypertension after intracardiac repair in patients with PA/VSD/MAPCAs.
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影响因子：
5.4
作者：
Dimopoulos K;Diller GP;Opotowsky AR;D'Alto M;Gu H;Giannakoulas G;Budts W;Broberg CS;Veldtman G;Swan L;Beghetti M;Gatzoulis MA
通讯作者：
Gatzoulis MA
影响因子：
3.5
作者：
Lim, Zek S.;Vettukattill, Joseph J.;Veldtman, Gruschen R.
通讯作者：
Veldtman, Gruschen R.
DOI：
10.1164/rccm.201706-1215oc
发表时间：
2018-02-15
影响因子：
24.7
作者：
Douschan, Philipp;Kovacs, Gabor;Olschewski, Horst
通讯作者：
Olschewski, Horst
影响因子：
1.5
作者：
J. Yasuhara;H. Yamagishi
通讯作者：
H. Yamagishi
影响因子：
4.6
作者：
Vaikunth, Sumeet S.;Bauser-Heaton, Holly;McElhinney, Doff B.
通讯作者：
McElhinney, Doff B.