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Impact Factors of Pulmonary Hypertension and Post-operative Incomplete Right Atrial Reverse Remodeling in Patients with Atrial Septal Defect Aged Twen Years and Over

Author: DingChao
Tutor: DongAiQiang
School: Zhejiang University
Course: Surgery
Keywords: Atrial septal defect Pulmonary Hypenension Right VentncularHypenrophy
CLC: R654.2
Type: Master's thesis
Year: 2012
Downloads: 16
Quote: 0
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Objective:To explore the impact factors of pulmonary hypertension and postoperative incomplete right heart reverse remodeling in adults with ASD. Method:Data of all adult ASD admissions, aged twenty years and over, in our hospital between June2010and October2011were obtained before and after a time of more than30days from the correction. The data included their baseline clinical features, chest plain radiographs, electrocardiograms, echocardiography and pulmonary function parameters. All data were analyzed as a retrospective controlled study. Result:44patients with ASD enrolled in this study. According to the analysis, we found that ASD patients with higher mean pulmonary artery pressure (MPAP) tended to have larger cardiothoracic ratio (p=0.004), larger ASD (p=0.025), larger left atrial diameters (p=0.011) and thinner systolic interventricular septum (p=0.023). Mean pulmonary artery pressure had a negative linear relationship with FEV1/FVC (correlation coefficient-5.684, p<0.001), but a positive linear relationship with right ventricular diastolic diameter (correlation coefficient3.073, p=0.002). All patients had large right atrium before correction, with their right atrial volume over21ml/m2. Through more than30days follow-up after surgery, there are11(35.5%) patients occurring incomplete right atrial reverse remodeling (iRAR). We found patients with iRAR have older ages (p=0.04), larger defects (p=0.012), larger preoperative left atrial diameters(p=0.009) and lower preoperative vital capacity (p<0.001). Conclusion:Higher pulmonary artery pressure in adult ASD admissions associates with lower pulmonary function and cardiac remodeling. The patient’s age, defect size, left atrial diameter and vital capacity can indicate the right atrial reverse remodeling and the prognosis of ASD surgical correction

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