Utku Arman ÖRÜN, Şeyma KAYALI, Mehmet Emre ARI, Selmin KARADEMİR, Vehbi DOĞAN, Özben CEYLAN, Senem ÖZGÜR, Mahmut KESKİN

Pulmonary vasoreactivity testing with inhaled iloprost in children with pulmonary hypertension related to congenital heart disease

Amaç: Bu çalışmada pulmoner hipertansiyonlu doğumsal kalphastalıklarında pulmoner vazoreaktiviteyi ölçmek amacıylakullanılan inhale iloprostun akut hemodinamik etkilerideğerlendirildi.Çalışmaplanı: Ekim 2005 - Ekim 2012 tarihleri arasındadoğuştan kalp hastalığına sekonder pulmoner hipertansiyontanısıyla izlenen ve inhale iloprost ile vazoreaktivite testiyapılan 51 hasta (29 erkek, 22 kız; ort. yaş 4.9 yıl; dağılım4 ay-16 yıl) retrospektif olarak değerlendirildi. İnhale iloprostöncesi ve sonrasında kardiyak basınç ve oksijen satürasyondeğerleri elde edildi; akım oranı, pulmoner ve sistemikvasküler dirençler hesaplandı. Pulmoner vasküler dirençte,pulmoner arter ortalama basıncında ve direnç oranında%10dan fazla azalma olması vazoreaktivite testine pozitifyanıt olarak değerlendirildi.Bul gu lar: Hastaların 44ünü (%86.3) ventriküler septal defekt,atriyal septal defekt, patent duktus arteriozus ve atriyoventrikülerseptal defekt oluştururken, yedisini (%23.7) kompleks kalphastalıkları oluşturuyordu. Hastaların 42sinde (%82.4)vazoreaktivite testi pozitif bulundu. Vazoreaktivite testi pozitifbulunan hastalarda iloprost öncesi ve sonrası ortalama pulmonerarter basınçları sırasıyla 59.7±13.4 mmHg ve 53.3±13.7 mmHg(p

Doğuştan kalp hastalığı ile ilişkili pulmoner hipertansiyonlu çocuklarda inhale iloprost ile pulmo nervazore aktivite testi

Background: This study aims to evaluate the acute hemodynamiceffects of inhaled iloprost used to measure pulmonaryvasoreactivity in congenital heart diseases with pulmonaryhypertension.Methods: Between October 2005 and October 2012, a total of 51patients (29 boys, 22 girls; mean age 4.9 years; range 4 monthsto 16 years) under follow-up with a diagnosis of pulmonaryhypertension secondary to congenital heart disease who underwentvasoreactivity test with inhaled iloprost were retrospectivelyevaluated. Cardiac pressure and oxygen saturation values wereobtained before and after iloprost inhalation, while flow ratio,pulmonary and systemic vascular resistances were calculated.A decrease greater than 10% in pulmonary vascular resistance,the mean pulmonary artery pressure, and resistance ratio wereconsidered as positive responses to the vasoreactivity test.Results: Forty-four patients (86.3%) had ventricular septaldefect, atrial septal defect, patent ductus arteriosus, andatrioventricular septal defect, while seven patients (23.7%)had complex heart diseases. Forty-two (82.4%) of thepatients had positive vasoreactivity test results. In positivevasoreactivity test patients, the pre- and post-iloprost meanpulmonary artery pressure values were 59.7±13.4 mmHg and53.3±13.7 mmHg (p

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