title: Hemodynamic Follow-Up in Adult Patients with Pulmonary Hypertension Associated with Atrial Septal Defect after Partial Closure.
abstract: OBJECTIVE
  We evaluated the hemodynamic statuses of patients after partial closure of atrial septal defects with fenestration due to pulmonary hypertension.
  
  
  METHODS
  Seventeen adult patients underwent partial atrial septal defect closure and follow-up cardiac catheterization. We analyzed hemodynamic data and clinical parameters before and after closure.
  
  
  RESULTS
  The median age at closure was 29 years old. The baseline Qp/Qs was 1.9 ± 0.6. The median interval from the operation to the cardiac catheterization was 27 months. The CT ratio decreased from 0.55 ± 0.07 to 0.48 ± 0.06 (p<0.05). The mean pulmonary arterial pressure decreased from 50.0 ± 11.5 mm Hg to 32.5 ± 14.4 mm Hg (p<0.05), and the pulmonary resistance index decreased from 9.2 ± 3.6 Wood units*m² to 6.3 ± 3.8 Wood units*m² (p<0.05). Eleven patients (64.7%) continued to exhibit high pulmonary resistance (over 3.0 Wood units*m²) after closure. These patients had significantly higher pulmonary resistance indices and mean pulmonary arterial pressures based on oxygen testing before the partial closures (p<0.05). However, no significant predictors of post-closure pulmonary hypertension were identified.
  
  
  CONCLUSIONS
  Despite improvement in symptoms and hemodynamics after partial closure of an atrial septal defect, pulmonary hypertension should be monitored carefully.
authors: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Jinyoung
authors: J
authors: Song
authors: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. herzhuh@skku.edu.
authors: June
authors: J
authors: Huh
authors: Department of Pediatrics, Sejong General Hospital, Sejong Cardiovascular Center, Bucheon, Korea.
authors: Sang-Yun
authors: SY
authors: Lee
authors: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: I-Seok
authors: IS
authors: Kang
authors: Department of Thoracic Surgery, Sejong General Hospital, Sejong Cardiovascular Center, Bucheon, Korea.
authors: Chang Ha
authors: CH
authors: Lee
authors: Department of Thoracic Surgery, Sejong General Hospital, Sejong Cardiovascular Center, Bucheon, Korea.
authors: Cheul
authors: C
authors: Lee
authors: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Ji-Hyuk
authors: JH
authors: Yang
authors: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Tae-Gook
authors: TG
authors: Jun
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010100:Oxygen; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Atrial septal defect; partial closure; pulmonary hypertension; pulmonary vascular resistance index