Long-term echocardiographic follow-up of a patient with primary pulmonary hypertension receiving iloprost inhalations

The benefits of surgical closure has been unclear in adult atrial septal defect (ASD) with severe pulmonary hypertension (PHT), and we tried to evaluate improvement of PHT and long-term survival after surgical closure compared to medical follow-up. Methods: From 1996 to 2006, we included a total of 71 adult ASD patients (age; 43±15 years) with severe PHT documented by echocardiography. The inclusion criteria were defined as ASD diameter > 15 mm, enlarged right ventricle, and the baseline peak velocity of tricuspid regurgitation (TR) ≥ 4.0 m/sec. We excluded 5 patients with Eisenmenger syndrome documented by cardiac catheterization. Surgical closure was performed on 55 patients (OP group) and the remaining 16 patients were followed up medically (MED group). The improvement of PHT was defined as TR velocity ≤ 3.5 m/sec on follow-up echo. Results: Baseline characteristics and clinical results were compared between the two groups in table . There were no significant differences in terms of gender, ASD diameter, cardiac rhythm, and TR velocity, but the MED group was significantly older. During follow-up of 46±33 months, there were 5 deaths in the MED group and no operative or late death in the OP group, and the 5-year actuarial survival rate of the OP group was significantly higher than the MED group (58±15%, p<0.05). On subgroup analysis according to age, the OP group showed significantly better survival rates than the MED group (p<0.05) in elderly patients (age > 50). In the OP group, TR velocity was significantly decreased from 4.5±0.4 to 3.0±0.7 m/sec on follow-up echo, and improvement of PHT was observed in 47 (85%) patients. On multivariate analysis, female gender and lower baseline TR velocity were the significant independent predictors of improved PHT after surgery. Conclusions: In adult ASD with severe PHT, surgical closure can be safely performed and improve PHT effectively. Especially in elderly patients, ASD closure is significantly related with the better survival rates.

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MILLER Banding Procedure for Treatment of Dialysis Access–Related Steal Syndrome, Pulmonary Hypertension, and Heart Failure

The American Surgeon ◽

10.1177/00031348211056259 ◽

2021 ◽

pp. 000313482110562

Author(s):

Ahmad Alqassieh ◽

Patrick B. Dennis ◽

Veena Mehta ◽

June Shi ◽

Angello Lin ◽

...

Keyword(s):

Heart Failure ◽

Pulmonary Hypertension ◽

Vascular Access ◽

Primary Patency ◽

Secondary Patency ◽

Dialysis Access ◽

Long Term Follow Up ◽

Steal Syndrome

A Minimally Invasive Limited Ligation Endoluminal-assisted Revision (MILLER) banding procedure has been used for treating patients with dialysis access–related steal syndrome (DASS) and high-flow vascular access–related pulmonary hypertension (PHT) and heart failure (HF). We performed a retrospective analysis of patients undergoing the MILLER procedure performed for DASS, HF, and PHT from our Vascular Access Database from September 2017 to October 2019. Outcomes included primary patency of banding, primary assisted patency, and secondary patency, using time-to-event analyses with Kaplan-Meier curves and life tables to estimate 6- and 12-month rates. A total of 13 patients (6 men and 7 women, mean age 60 ± 14 years) underwent the MILLER procedure, 6 patients for DASS and 7 patients for pulmonary hypertension and heart failure (PHT/HF). Technical success was achieved in all patients. The longest duration of follow-up was 28 months (median 12 months [IQR 7, 19]). One patient died at 1 month after the intervention due to stroke. One patient developed access thrombosis of the graft 3 days after the procedure. Repeat banding was required in 1 patient 8 months after the first procedure. The 6-month primary patency rate of banding following this procedure was 83% while the 12-month rate was 66%. The 6- and 12-month secondary patency rates were 87% and 75%, respectively. The MILLER procedure can be performed for DASS and PHT/HF with improvement of symptoms and good long-term patency rates. Additional interventions to maintain patency and efficacy are required on long-term follow-up.

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Echocardiographic evaluation of right ventricular size and function in patients with primary pulmonary hypertension treated with long term prostacyclin infusion

Journal of Cardiac Failure ◽

10.1016/s1071-9164(98)90040-9 ◽

1998 ◽

Vol 4 (3) ◽

pp. 11

Author(s):

James T. Fitzpatrick ◽

John Gorcsan ◽

Tammy Tokarczyk ◽

RenéJ. Alvarez ◽

Guy A. MacGowan ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Right Ventricular ◽

Primary Pulmonary Hypertension ◽

Ventricular Size ◽

Right Ventricular Size ◽

Echocardiographic Evaluation ◽

And Function

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BCR-ABL1–Negative Chronic Myeloproliferative Neoplasms and Pulmonary Hypertension: A Prospective Long-Term Follow-up Study of the Impact of Pulmonary Hypertension on Survival

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/j.clml.2020.08.006 ◽

2020 ◽

Author(s):

Kadriye Bahriye Payzin ◽

Kaan Savasoglu ◽

Inci Alacacioglu ◽

Elif Ebru Dalgic ◽

Betul Bolat Kucukzeybek ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Myeloproliferative Neoplasms ◽

Chronic Myeloproliferative Neoplasms ◽

Follow Up Study ◽

Long Term Follow Up ◽

The Impact

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Residual Pulmonary Hypertension More than 20 Years after Repair of Shunt Lesions

Medicina ◽

10.3390/medicina56060297 ◽

2020 ◽

Vol 56 (6) ◽

pp. 297

Author(s):

Dovilė Jančauskaitė ◽

Virginija Rudienė ◽

Gabrielius Jakutis ◽

Laurie W Geenen ◽

Jolien W Roos-Hesselink ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Surgical Repair ◽

Significant Proportion ◽

University Hospital ◽

Right Heart ◽

Long Term Outcome ◽

Right Heart Catheterisation ◽

Study Results

Background and Objectives: After successful surgical repair of a congenital shunt lesion, pulmonary hypertension (PH) often disappears. However, PH can persist long-term after the closure. This study aimed to assess the prevalence of PH long-term after surgical repair of congenital heart disease (CHD), and to evaluate the outcomes and preoperative factors related to residual PH. Materials and Methods: In this retrospective cohort study, we reviewed patients who underwent right heart catheterisation in Vilnius University Hospital Santaros Klinikos during the period of 1985–2007. Among 4118 right heart catheterisations performed, 160 patients underwent congenital systemic-to-pulmonary shunt repair at a young age (<18 years) and had pre-operative PH. Half of the patients were foreigners whose follow-up data were unavailable. Eventually, 88 patients with available follow-up data were included in this study. Results: The median age at diagnosis of CHD with PH was 0.8 (0.6–3.0) and 1.1 (0.6–3.9) years at surgery (50% females). Residual PH was assessed 9.5 years after surgery and observed in 30.7% (n = 27) of the patients. It was associated with having more than one shunt (44.4% (n = 12), p = 0.016) and higher median pulmonary vascular resistance (3.4 (2.5–6.5) vs. 2.2 (1.0–3.7), p = 0.035) at baseline. After a median follow-up of 21 (15–24) years, 9.1% of the patients were deceased. Kaplan–Meier survival analysis revealed significantly higher mortality in the residual PH group (p = 0.035). Conclusions: Residual PH affects a significant proportion of patients after surgical repair of a shunt lesion and is associated with worse long-term outcome.

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