الفهرس Only 14 pages are availabe for public view
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Abstract
This study was conducted to determine the factors which reflect the degree of pulmonary hypertensive state related to congenital left to right shunt lesions and the expected operability criteria.Subject and method:A retrospective study was conducted to revise the electronically stored files of all children with left to right shunt presented to the catheterization laboratory for haemodynamic study in Cairo University Children Hospital between January 2010 and September 2015. The study included 85 patients with congenital left to right shunt atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA) and endocardial cushion defect (ECD). They were all referred to catheterization laboratory to undergo diagnostic cardiac catheterization. The following data were collected; demographic data, CXR, ECG, Echocardiography details and Cardiac catheterization findings including angiographic confirmation of lesions and haemodynamic data.Results:The patients{u2019} ages ranged between 5 months and 18 years. Their Final operability is 70.6%, while final inoperability is 24.7% and 4.7% have no enough data. Being operable on final criteria is significantly related to mPAP (Room air (R.A.), cut off value = 54; Hyperoxia (H.O.), cut off value =49.5), Qp/Qs (R.A., cut off value = 1.21; H.O., cut off value = 3.70), Pp/Ps (H.O., cut off value = 0.69), Rp/Rs (R.A., cut off value = 0.50; H.O., cut off value = 0.15), PVR/SVR (R.A., cut off value = 0.73; H.O., cut off value = 0.17), PVRI (R.A., cut off value = 6; H.O., cut off value = 1.5), Pulmonary artery saturation (H.O., cut off value = 94.5), PACI (R.A., cut off value = 0.52), Age (3.1 years has a high sensitivity to operability, 1.2 years has a high specificity to inoperability)