Related Experiment Video
Updated: May 23, 2026
Induction of Right Ventricular Failure by Pulmonary Artery Constriction and Evaluation of Right Ventricular Function in Mice
Published on: May 13, 2019
Pulmonary vascular resistance in repaired congenital diaphragmatic hernia vs. age-matched controls
Matthew E Zussman1, Michelle Bagby, D Woodrow Benson
1The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. matthew.zussman@cchmc.org
Insights
Children with repaired congenital diaphragmatic hernia (CDH) have elevated pulmonary vascular resistance (PVR). Early cardiac catheterization may be beneficial for assessing PVR in these patients.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Pulmonary Hypertension
Background:
- Infants and children with repaired congenital diaphragmatic hernia (CDH) often experience delayed growth and development.
- This developmental delay may be linked to persistent, unrecognized increased pulmonary vascular resistance (PVR).
Purpose of the Study:
- To investigate pulmonary vascular resistance (PVR) in young children (6-36 months) with repaired congenital diaphragmatic hernia (CDH).
- To compare PVR in CDH patients with a control group undergoing patent ductus arteriosus (PDA) closure.
Main Methods:
- Retrospective review of cardiac catheterization data from 8 CDH patients and 10 control patients (ages 6-36 months) between 2007-2010.
- Analysis of indexed pulmonary blood flow (Qp), mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP), and PVR.
Main Results:
- CDH patients exhibited significantly higher mPAP and PVR compared to controls.
- Pulmonary blood flow (Qp) was significantly lower in the CDH group.
- Pulmonary capillary wedge pressure (PCWP) showed no significant difference; echocardiograms revealed pulmonary hypertension in less than half of CDH patients.
Conclusions:
- Children aged 6-36 months with repaired CDH demonstrate significantly increased PVR.
- Early consideration of cardiac catheterization is warranted for these patients to evaluate PVR.
Introduction:
Infants and children with repaired congenital diaphragmatic hernia (CDH) often continue to show delayed growth and development that may be, in part, secondary to unrecognized persistence of increased pulmonary vascular resistance (PVR).
Methods:
Data were reviewed from all patients ages 6-36 mo with repaired CDH who underwent cardiac catheterization from 2007 to 2010 and were compared to data from a control population of patients undergoing percutaneous closure of a patent ductus arteriosus (PDA). Indexed pulmonary blood flow (Qp), mean pulmonary artery pressure (mPAP), pulmonary capillary wedge pressure (PCWP), and PVR were examined.
Results:
Data from 8 CDH patients and 10 control patients were examined. The mPAP (22.5 ± 3.33 vs. 18.2 ± 4.13 mm Hg) and PVR (3.66 ± 0.79 vs. 1.22 ± 0.4 iwU (indexed Wood's units)) were both significantly elevated in the CDH population, whereas the Qp (4.08 ± 1.43 vs. 6.82 ± 1.46 l/min/m(2)) was significantly lower in this population. There was no significant difference in pulmonary capillary wedge pressure (PCWP). Less than half of the CDH patients had signs of pulmonary hypertension (PH) on echocardiogram.
Discussion:
Our data suggest that children who are ages 6-36 mo with repaired CDH have significantly increased PVR compared with controls and early consideration of cardiac catheterization may be warranted.
