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Post-operative course of pulmonary artery pressure after complete atrioventricular canal defect repair

Part of: Surgery Atrioventricular Septal Defect (AVSD)

Published online by Cambridge University Press:  11 June 2021

Marie Emeline Pierre Louis ,
Adnan Bhutta ,
Adrian Holloway  and
Peter Gaskin Open the ORCID record for Peter Gaskin [Opens in a new window]
Marie Emeline Pierre Louis
Affiliation:
Houston Healthcare Clear Lake, Houston, TX, USA
Adnan Bhutta
Affiliation:
Division of Pediatric Critical Care, University of Maryland School of Medicine, Baltimore, MD, USA
Adrian Holloway
Affiliation:
Division of Pediatric Critical Care, University of Maryland School of Medicine, Baltimore, MD, USA
Peter Gaskin*
Affiliation:
Division of Pediatric Cardiology, University of Maryland School of Medicine, Baltimore, MD, USA
*
Author for correspondence: Peter Gaskin, Division of Pediatric Cardiology, University of Maryland School of Medicine, Baltimore, MD, USA. Tel: 410-328-4348; Fax: 410-328-8670. E-mail: [email protected]
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Abstract

Complete atrioventricular canal defect is a CHD associated with intra-cardiac shunting of blood, which can lead to irreversible changes in pulmonary vascular resistance and pulmonary artery hypertension if unrepaired. Patients with Trisomy 21 are at risk for early development of pulmonary artery hypertension if left uncorrected.1,2

Objectives:

The purpose of this study is to describe the evolution of pulmonary artery hypertension after repair of complete atrioventricular canal defect and to determine the time to normalisation of pulmonary artery pressure in both patients with and without Trisomy 21.

Methods:

This is a single centre, retrospective analysis of patients with complete atrioventricular canal defect admitted for surgical repair at the University of Maryland Medical Center from 2005 to 2015. T-test or Mann–Whitney test and Chi-Square or Fisher’s exact tests were used to compare the two groups (patients with Trisomy 21 and those without). Repeated measures of analysis of variance and serial measurement analysis were performed.

Results:

Twenty-nine patients meeting the inclusion criteria underwent repair of complete atrioventricular defects during the study period. The right ventricular pressure estimate remained elevated over time and did not show a significant difference between the two groups. Right ventricular to systolic blood pressure ratios for all patients remained > 0.5 over the time periods assessed.

Conclusions:

Our study suggests that in patients with complete atrioventricular canal defects, the right ventricular pressure remains elevated and does not normalise on echocardiograms performed up to one year after surgery, suggesting a sustained elevation in pulmonary vascular resistance.

Keywords

Pulmonary vascular resistanceatrioventricular canal defectpulmonary artery hypertension
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 3 , March 2022 , pp. 398 - 404
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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