Systematical approach to pulmonary hepertension (ph) in children with congenital heart defects (chd)

ABSTRACT Criteria used for estimation of surgical risk in children with CHD and PH have been controversial. The clinical, hemodynamic and angiographic data were analised in 23 candidates for

surgical treatment. The data were scored as follows: Clinical grade 1, 2 or 3 according to signs of pronounced, mild or absent pulmonary congestion and left ventricular overload.

Hemodynamics: 1- pulmonary to systemic resistance ratio PR/SR less than 0.5; 2- PR/SR≥0.5 with a greater than 30% decrease in PR after vasodilators; 3- PR/SR≥0.5, no significant

vasodilation. Pulmonary wedge angiography: 1- mild dilatation of arteries, normal or increased capilary haze; 2- difuse tortuosity of muscular arteries and decreased background haze; 3-

accentuated tortuosity, arterial retaining of contrast material, sparse or absent capilary network. An optimistic opinion was established for mean of scores equal to or less than 2.0. The

data were compared with histopathological findings wich were considered advanced if a difuse grade III (Hearth-Edwards) or an alveolar/artery ratio≥12:1 were observed. The results were in

accordance in 16 patients (P = 0.04). Twenty children underwent corrective or paliative surgery. Only 12 patients with an optimistic result (mean of scores) underwent a corrective procedure.

One child died on the postoperative period as a consequence of infectious disease, not related to pulmonary vascular problems. On the basis of these results, the scored analysis of multiple

data was considered a safe method for evaluation of surgical risk in patients with congenital heart defects and pulmonary hypertension. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND

AFFILIATIONS * Heart Institute, University of Sao Paulo, Brazil A A B Lopes, V D Aiello, M A Ratti, A Riso & M Ebaid Authors * A A B Lopes View author publications You can also search

for this author inPubMed Google Scholar * V D Aiello View author publications You can also search for this author inPubMed Google Scholar * M A Ratti View author publications You can also

search for this author inPubMed Google Scholar * A Riso View author publications You can also search for this author inPubMed Google Scholar * M Ebaid View author publications You can also

search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Lopes, A., Aiello, V., Ratti, M. _et al._ SYSTEMATICAL

APPROACH TO PULMONARY HEPERTENSION (PH) IN CHILDREN WITH CONGENITAL HEART DEFECTS (CHD). _Pediatr Res_ 22, 368 (1987). https://doi.org/10.1203/00006450-198709000-00026 Download citation *

Issue Date: 01 September 1987 * DOI: https://doi.org/10.1203/00006450-198709000-00026 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get

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