Related Experiment Video
Updated: Sep 26, 2026
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
[Postoperative hemodynamic parameter follow-up in children with severe pulmonary resistance hypertension due to
Wei-hua Zhu1, Jian-hua Li, Xiong-kai Zhu
1The Affilliated Children's Hospital, College of Medical Sciences, Zhejiang University, Hangzhou 310003, China.
Insights
Early surgery for children with severe pulmonary hypertension (PH) due to ventricular septal defect (VSD) leads to optimal long-term outcomes. Children operated on before age 2 had normalized hemodynamic parameters, unlike older children.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Pulmonary Hypertension Research
Context:
- Ventricular septal defect (VSD) can lead to severe pulmonary hypertension (PH).
- The timing of surgical intervention for PH in children with VSD is critical for prognosis.
- Pulmonary vascular disease development is a concern in untreated PH.
Purpose:
- To investigate the correlation between the age of surgical intervention and long-term prognosis in pediatric patients with severe PH secondary to VSD.
- To compare hemodynamic outcomes in children with PH due to VSD based on early (<2 years) versus later (≥2 years) surgical repair.
Summary:
- Forty children with severe PH due to VSD were categorized into two age groups for surgery: <2 years and ≥2 years.
- Hemodynamic parameters, including pulmonary-to-systemic pressure and resistance ratios, were assessed via cardiac catheterization pre-surgery, 1 week post-surgery, and 5-7 years later.
- The group undergoing early surgery (<2 years) demonstrated normalized hemodynamic parameters long-term, whereas the older group showed persistent pulmonary arterial resistance abnormalities.
Impact:
- Early surgical repair in children with VSD-associated PH significantly improves long-term hemodynamic status.
- Timely intervention can prevent or mitigate the progression of pulmonary vascular disease.
- This study underscores the importance of age at operation for optimizing surgical results in pediatric PH due to VSD.
Objective:
To study the relationship between the age at operation and prognosis in children with severe pulmonary hypertension (PH) due to ventricular septal defect (VSD).
Methods:
Forty children with severe PH (increased total pulmonary circulation resistance)due to VSD were divided into two groups based on age at operation(Group I aged less than 2 years and group II more than 2 years). The hemodynamic parameter follow-up was measured by cardiac catheterization at presurgery, one week after surgery and 5-7 years postoperatively.
Results:
The ratio of pulmonary arterial pressure and systemic arterial pressure (pp/ps),pulmonary resistance and systemic resistance (R(p)/R(s)), and pulmonary vascular resistance (PVR) and small pulmonary arterial resistance (PAR) were significantly different in two groups (P<0.01). During follow-up in the group less than 2 years, all the hemodynamic parameters were at normal level, while in the group more than 2 years, only p(p)/p(s) and R(p)/R(s) were close to normal level. The pulmonary arterial resistance was still abnormal.
Conclusion:
An early operation may be the only way to gain optimal long term result of surgery and decrease the incidence of pulmonary vascular disease in children with PH due to VSD.
