Long-term persistent pulmonary hypertension after atrial septal defect occlusion in elderly patients
Yu Huimei
Zhang Chun
Ke Yutong
Li Xiaoming
Wu Shan
An Bojing
Yao Luchan
Zhang Weicong
Abstract：Objective To observe the occurrence of persistent pulmonary hypertension after occlusion in elderly patients with atrial septal defect.Methods From July 2016 to January 2018,14 elderly patients with atrial septal defect who successfully completed occlusion surgery in Beijing Anzhen Hospital,Capital Medical University,including 4 males and 10 females,with an average age of (58 ± 5) years,were sequentially enrolled.According to preoperative transthoracic echocardiography,the patients were divided into pulmonary hypertension(PH) group (5 cases) and non-PH group (9 cases).Right heart function parameters were recorded before and 12 months after surgery.Correlation between pulmonary artery pressure and right heart function parameters was analyzed.Clinical outcomes of the patients were observed during 12 months follow-up.Results Pulmonary systolic pressure before surgery in PH group was significantly higher than that in non-PH group(P ＜ 0.05).Twelve months after surgery,right ventricular end-diastolic volume and right ventricular end-systolic volume in PH group were significantly greater[(57 ± 11)ml vs (41 ± 15)ml,(41 ±9)ml vs (22 ±14) ml] and right ventricular ejection fraction was significantly lower[(29 ± 9) ％ vs (50 ± 13) ％] than those in non-PH group (all P ＜ 0.05).Pulmonary systolic pressure was negatively correlated with right ventricular ejection fraction(r =-0.749,P ＜ 0.001) and positively correlated with right ventricular end-diastolic volume and right ventricular end-systolic volume(r =0.810,0.873;both P ＜ 0.001).One patient in PH group died of acute myocardial infarction and 4 patients developed persistent PH during follow-up.No adverse event occurred in non-PH group.Conclusion In elderly patients with atrial septal defect occlusion,right ventricular function decline and right ventricular remodeling deteriorate with the increase of pulmonary artery pressure;low pulmonary artery pressure indicates better prognosis.
Keywords：Atrial septal defectPulmonary hypertension
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 1151-1154 )