Mustafa PAÇ, İrfan TAŞOĞLU, Ahmet Vedat KAVURT, Sinan Sabit KOCABEYOĞLU, Doğan Emre SERT, Feyza Ayşenur PAÇ

Perioperatif inhale iloprost ile tedavi edilen ciddi pulmoner arteriyel hipertansiyonlu çocuklarda doğuştan kalp hastalıklarının cerrahi onarımının uzun dönem sonuçları

Amaç: Bu çalışmada perioperatif inhale iloprost ile tedavi edilen doğuştan kalp hastalığı ilişkili pulmoner arteriyal hipertansiyonu olan hastaların uzun dönem sonuçları değerlendirildi. Çalışma planı: 2008 - 2011 yılları arasında, ventriküler septal defekt ve ilişkili şiddetli pulmoner arteriyel hipertansiyonu olan, vazoreaktivite testi pozitif toplam 16 çocuğa (10 erkek, 6 kız; ort. yaş 4.97 yıl; dağılım 8 ay-17 yıl), cerrahi onarım öncesinde ortalama 40 (dağılım 7-90) gün süreyle inhale iloprost uygulandı. İnhaler iloprost, ameliyat sonrasında beş gün süreyle kullanıldı. Pulmoner arteriyel hipertansiyon tanısı, sağ ve sol kalp kateterizasyonu ile konuldu ve ameliyattan hemen önce, sonrasında 30. günde ve beş yıl boyunca yıllık olarak ekokardiyografi ile değerlendirildi. Bulgular: İlk başvuru esnasında ortalama sistolik ve ortalama pulmoner arter basınçları sırasıyla 81 (dağılım 51-104) mmHg ve 60 (dağılım 41-77) mmHg idi. İnhaler iloprost uygulamasından sonra, ekokardiyografik bulgulara göre, yaklaşık 18 mmHg düşüş izlendi (p

Long-term results of surgical repair of congenital heart defects in children with severe pulmonary arterial hypertension treated with perioperative inhaled iloprost

Background: This study aims to evaluate the long-term outcomes of patients with pulmonary arterial hypertension associated with congenital heart disease treated with inhaled iloprost perioperatively.Methods: Between 2008 and 2011, 16 children (10 boys, 6 girls; mean age 4.97 years; range 8 months to 17 years) with a ventricular septal defect and associated severe pulmonary arterial hypertension who had a positive vasoreactivity were administered inhaled iloprost for a mean duration of 40 (range 7 to 90) days before the surgical repair. Inhaled iloprost was used for five days postoperatively. Pulmonary arterial hypertension was diagnosed by right and left heart catheterization and evaluated with echocardiography immediately before the operation, 30 days postoperatively, and annually for five years.Results: The mean systolic and mean pulmonary artery pressures at the initial presentation were 81 (range 51 to 104) mmHg and 60 (range 41 to 77) mmHg, respectively. After the administration of inhaled iloprost, there was a decline of about 18 mmHg according to the echocardiographic findings (p

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