Hemodynamic Follow-Up in Adult Patients with Pulmonary Hypertension Associated with Atrial Septal Defect after Partial Closure.

PURPOSE

We evaluated the hemodynamic statuses of patients after partial closure of atrial septal defects with fenestration due to pulmonary hypertension.

MATERIALS AND 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 unitsm² to 6.3 ± 3.8 Wood unitsm² (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.

CONCLUSION

Despite improvement in symptoms and hemodynamics after partial closure of an atrial septal defect, pulmonary hypertension should be monitored carefully.