Cardiology in the Young ( IF 0.9 ) Pub Date : 2022-08-11 , DOI: 10.1017/s104795112200244x Kanta Kishi 1 , Jirayut Jarutach 2 , Yinn Khurn Ooi 3 , Ngie Liong Wong 4 , Marhisham Che Mood 5 , Geetha Kandhavello 5 , Mazeni Alwi 5 , Ming Chern Leong 5
Current guidelines discourage shunt closure in patients with pulmonary vascular resistance index >8 Wood units x m2. The study examined the long-term outcome of patients over 15 years old, with pulmonary vascular resistance index >8 Wood units x m2 and patent ductus arteriosus.
Materials and methods:This was a multi-institutional, retrospective study involving all consecutive patients (>15 years old) with patent ductus arteriosus and severe pulmonary hypertension. Patients who had patent ductus arteriosus closure were divided into the Good (no death or hospital admissions due to worsening pulmonary hypertension) and the Poor Outcome groups and these groups were compared.
Results:Thirty-seven patients [male: 9 (24.3%); mean age: 30.49 ± 9.56 years; median follow-up: 3 (IQR: 1.5,10) years] were included from four centers. Twenty-two patients who underwent patent ductus arteriosus closure, 15 (71.4%) had good outcomes while 7 (28.6%) had poor outcomes. Pulmonary vascular resistance index and pulmonary to systemic resistance ratio (Rp:Rs) were lower in the Good Outcome Group (14.35 ± 1.66 Wood units x m2 vs. 20.07 ± 2.44; p = 0.033 and 0.44 ± 0.16 vs. 1.08 ± 1.21; p = 0.042). Haemoglobin concentrations (<14.3 g/dL) were associated with good long-term outcomes in the Closed Group.
Conclusions:Patients with patent ductus arteriosus with severe pulmonary hypertension have a dismal outcome with or without closure. High haemoglobin levels at the time of occlusion predict a worse outcome for patients with patent ductus arteriosus and pulmonary hypertension.
中文翻译：
闭塞时的高血红蛋白水平预示着动脉导管未闭和肺动脉高压患者的预后较差
介绍：
目前的指南不鼓励肺血管阻力指数 >8 Wood 单位 xm 2的患者关闭分流器。该研究考察了 15 岁以上、肺血管阻力指数 >8 Wood 单位 xm 2且动脉导管未闭患者的长期结果。
材料和方法：这是一项多机构回顾性研究，涉及所有连续患有动脉导管未闭和严重肺动脉高压的患者（> 15 岁）。动脉导管未闭封堵术的患者被分为“良好”组（没有因肺动脉高压恶化而死亡或入院）和“不良结果”组，并对这些组进行比较。
结果：37例患者[男性：9例（24.3%）；平均年龄：30.49±9.56岁；中位随访时间：3（IQR：1.5,10）年]来自四个中心。22 例接受动脉导管未闭封堵术的患者中，15 例（71.4%）预后良好，7 例（28.6%）预后较差。良好结果组的肺血管阻力指数和肺与全身阻力比 (Rp:Rs) 较低（14.35 ± 1.66 Wood 单位 xm 2对比 20.07 ± 2.44；p = 0.033 和 0.44 ± 0.16 对比 1.08 ± 1.21；p = 0.042）。封闭组中的血红蛋白浓度（<14.3 g/dL）与良好的长期结果相关。
结论：患有严重肺动脉高压的动脉导管未闭患者无论是否闭合，结局都很惨淡。闭塞时的高血红蛋白水平预示着动脉导管未闭和肺动脉高压患者的预后较差。
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