講演情報
[I-OR05-03]Therapeutic effects of treat and repair strategy in pediatric patients with pulmonary arterial hypertension and simple congenital heart defects
○Xiaofeng Wang, Xu Wang, Zhiyuan Zhu (Department of PICU, FuWai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China)
キーワード：
Pulmonary arterial hypertension、Congenital heart disease、Treat and repair strategy
Objective: Surgical indications for patients with pulmonary arterial hypertension (PAH) and simple congenital heart defects (CHD) are controversial. There have been no studies on pediatric patients.Methods: This study included pediatric patients with PAH and simple CHD who underwent corrective repair between 2012 and 2021. According to the preoperative treatment strategies, the patients were divided into a regular group (group 1) and a treat-and-repair group (group 2). Postoperative recovery and follow-up results were compared.Results: A total of 33 patients were included in this study. Group 1 consisted of 19 patients, whereas group 2 consisted of 14 patients. The pulmonary vascular resistance index in Group 2 was higher than that in Group 1 (10.9±4.1 vs 8.2±1.6 WU&chim2, p=0.031). There were no differences in postoperative recovery (P >0.05). During follow-up, five patients were lost (three in Group 1 and two in Group 2). The median follow-up period was 59 months. One patient died in Group 1, and two patients died in Group 2. There was no significant difference in the survival curve (p=0.39). At the last follow-up, another seven patients had experienced a non-low-risk condition, with a total of three non-low-risk patients in group 1 and seven in group 2. According to ROC curve, a preoperative PVRi < 8.2 WU&chim2 can predict postoperative persistent low-risk state.Conclusion: In pediatric patients with PAH and simple CHD, the treatment and repair strategies may provide surgery opportunities, PVRi should be less than 8 WU&chim2.