講演情報
[III-OR30-01]The effects of standardized intravenous treprostinil in pulmonary arterial hypertension patients after total cavo-pulmonary connection procedure
○Xiaofeng Wang, Xu Wang, Shilin Wang (Department of PICU, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China)
キーワード：
Total cavo-pulmonary connection、Pulmonary hypertension、Treprostinil
Objective: For high-risk patients (mean pulmonary arterial pressure, mPAP > 15 mmHg), the treprostinil is core treatment after Total cavo-pulmonary connection (TCPC). Methods: This was a retrospective study. High-risk patients from 2015 to 2022 were included. Since the use of treprostinil was standardized in 2021, the patients in 2020 and before were included in group 1, others were in group 2. The hemodynamic parameters were compared before and after the treprostinil. The differences of demographic characteristics, surgical data and postoperative recovery were compared between the two groups.Results: A total of 51 patients were included. Group 1 included 35 patients who received treprostinil at 12 ± 4 ng/(kg&chimin). Group 2 included 16 patients at 22 ± 7 ng/(kg&chimin). There were no differences in demographic characteristics, surgical data (p > 0.05). After 24 h of treprostinil treatment, the mPAP in group 1 reduced from 17 ± 3 to 15 ± 2 mmHg (p < 0.001), and in group 2 from 17 ± 2 to 14 ± 2 mmHg (p < 0.001). Patients in Group 2 exhibited a reduced duration of mechanical ventilation, 19 (11, 25) vs 69 (23, 189) hours, p = 0.001; a shorter stay in postoperative length of stay, 27 (17,55) vs 39 (29,58) days, p = 0.032. Patients in Group 2 exhibited a lower incidence of thromboembolic events, 0 vs 26%, p = 0.043; and renal replacement therapy, 0 vs 31%, p = 0.011.Conclusion: Treprostinil reduces pulmonary artery pressure after TCPC procedure. The standardized application can improve the postoperative recovery.