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[Evolution of lesser circulation hypertension in patients with congenital heart defects based on the example of an
Insights
Ventricular septal defect can lead to elevated pulmonary circulation pressure, especially in large defects. Surgical rehabilitation may help reduce pressure, but it can increase throughout life in some cases.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Pulmonary Hypertension
Context:
- Pulmonary circulation pressure is a critical indicator in patients with ventricular septal defect (VSD).
- Understanding pressure dynamics is essential for managing VSD and its complications.
- Normal pulmonary circulation values are established using data from healthy individuals.
Purpose:
- To analyze direct pressure measurements in the pulmonary circulation of VSD patients.
- To establish normal pulmonary circulation pressure values for comparison.
- To evaluate the long-term effects of surgical rehabilitation on pulmonary pressure in VSD patients.
Summary:
- Direct pressure measurements were analyzed in 452 VSD patients (12 months to 37 years) and compared to 150 healthy individuals.
- Repeated measurements in 46 VSD patients (18 months to 23 years) and follow-up in 85 post-surgery patients (up to 7 years) were assessed.
- Systolic pressure decreases with age in VSD patients up to 7 years, but large defects often lead to lifelong pressure increase.
Impact:
- Findings provide insights into the natural history of pulmonary circulation pressure in VSD.
- The study highlights the challenges in managing pulmonary hypertension associated with large VSDs.
- Results inform clinical decisions regarding surgical intervention and long-term monitoring of VSD patients.
Abstract:
The results of direct pressure measurement in pulmonary circulation in 452 patients with ventricular septal defect (216 males and 236 females), whose age ranged from 12 months to 37 years, were analysed. The findings of diagnostic catheterization of the heart in 150 practically healthy persons 12 months to 40 years of age were used to elaborate the normal values of pressure in pulmonary circulation. The results of pressure measurement in pulmonary circulation repeated at intervals of 1 to 6 years in 46 patients with ventricular septal defect, 18 months to 23 years of age, were analysed. Reverse evolution of pressure in pulmonary circulation after surgical rehabilitation was followed up in 85 patients in 1, 2, 3, 5, and 7 years after the operation. At the age of 12 months to 7 years, systolic pressure in the right ventricle and pulmonary artery comes down to a possible minimum due to expenditure of the adaptational reserve. In large ventricular septal defects, however, the organism proves incapable of reducing the pressure in the early and first periods of childhood as a rule, and so the pressure increases throughout life.