Volume 29, Issue 3
DOI: 10.24205/03276716.2020.748
Analysis of the effect of interventional therapy for congenital heart disease complicated with pulmonary artery hypertension
Abstract
Objective: The diagnosis and treatment process and the follow-up results of 249 congenital heart disease (CHD) patients complicated with pulmonary artery hypertension (PAH) were summarized and analyzed to improve the therapeutic effect.
Methods: The clinical data and related auxiliary examinations of 249 patients with CHD complicated with PAH from January 2014 to December 2018 were analyzed retrospectively. The age of the patients was (24.81±5.78) years old. The patients were followed up regularly after drug treatment and interventional therapy, and their symptoms and signs were monitored.
Results: A total of 175 patients (70.3%) were followed up for 3 months to 5 years. After that, the condition was significantly improved. The cardiac function of 62 patients was significantly improved above grade II, and the cardiothoracic ratio was reduced in varying degrees. Seventeen patients died, including 5 cases of central failure, 4 cases of sudden death, 1 case of postoperative pulmonary hypertension, 4 cases of dyspnea, 1 case of sudden death after cold injection, and 2 cases of unknown cause. Adverse reactions occurred in 73 patients, including hemoptysis, arrhythmia, heart failure, and syncope. The survival time of the patients was 0.78-11.51 years. Pulmonary artery systolic pressure and left ventricular ejection fraction decreased significantly. SpO2 and HGB increased significantly after three treatments, while BNP, total bilirubin, and uric acid levels tended to decrease. In the basic state, the values of Qp/Qs, PVRI, and Rp/RS were 1.02±0.56, 24.86±7.56, 1.01±0.34 respectively. After treatment, the three values changed to 1.34±0.67, 19.98±6.45, 0.77±0.12 respectively.
Conclusion: For patients with CHD complicated with PAH, early diagnosis should be strengthened and appropriate treatment methods and timing should be selected to improve the cure rate and prognosis.
Keywords
Congenital heart disease, Pulmonary artery hypertension, Cardiac function, Hemodynamics, Cardiac catheterization.