Correlation between pulmonary vascular change and hemodynamics in patients with complete atrioventricular septal defect.
OBJECTIVE
The study of the pulmonary vasculature in Taiwanese with atrioventricular septal defect has not been reported previously. This study investigated the correlation between pulmonary vascular change and hemodynamics in these patients.


METHODS
Ten children with complete atrioventricular defect, 8 of whom had Down syndrome, underwent open lung biopsy. Their age ranged from 8 months to 6 years (mean, 2 years 7 months). Cardiac catheterization was performed and the systolic pressures of pulmonary and systemic arteries were measured immediately before cardiopulmonary bypass (CPB) and immediately after cardiac repair in 9 patients, and expressed as a ratio of pulmonary to systemic systolic pressure (Pp/Ps).


RESULTS
Medial hypertrophy and intimal proliferation were prominent in 7 patients with pulmonary hypertension. The alveolar wall muscular arteries and percent arterial medial thickness increased significantly with increasing post-repair Pp/Ps, preoperative Pp/Ps, pulmonary arteriolar resistance index and pre-CPB Pp/Ps (p < 0.02). The arteries present per 100 alveoli were inversely correlated with the above mentioned hemodynamic parameters (p < 0.02).


CONCLUSIONS
The results of qualitative and quantitative analyses of the pulmonary vasculature in patients with complete atrioventricular defect correlated well with pre-and postoperative pulmonary arterial pressure and can be used to predict the postoperative pulmonary arterial pressure.
Wu
Chiou-Sen
CS
Department of Pediatrics, Taipei Municipal Chung Hsin Hospital, Taipei, Taiwan.
Chiu
Ing-Sh
IS
Wu
Shye-Jao
SJ
How
Shu-Wen
SW
Chen
Ming-Ren
MR
Wang
Jou-Kou
JK
Wu
Mei-Hwan
MH
D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000473:pathology* / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D006984:Hypertrophy; D007223:Infant; D008168:Lung / Q000098:blood supply* / Q000473:pathology*; D008297:Male