Is lung biopsy useful for surgical decision making in congenital heart disease?
| Autor: | Gaetano Thiene, S Biscaglia, Luciano Daliento, P A Pellegrino, Alessandro Mazzucco, M Carminati, M Giulia Gagliardi, Carla Frescura, Vincenzo Gallucci |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Heart Defects Congenital Male congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Pulmonary Circulation Heart disease Adolescent Biopsy Lung biopsy Risk Factors Ductus arteriosus medicine Humans Vascular Diseases Child Lung medicine.diagnostic_test business.industry Vascular disease Age Factors Hemodynamics Infant General Medicine Middle Aged medicine.disease Cardiac surgery Surgery medicine.anatomical_structure Great arteries Child Preschool Vascular resistance Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 5(3) |
| ISSN: | 1010-7940 |
| Popis: | Sixty patients with congenital heart disease (CHD), age range 3 months-45 years (median 2 years), underwent lung biopsy to exclude pulmonary vascular disease (PVD): 25 had an atrioventricular (AV) septal defect, 14 a ventricular septal defect (VSD), 7 a complete transposition of the great arteries (TGA) + VSD, 3 an atrial septal defect, and 2 a patent ductus arteriosus; 9 had other malformations. Scoring of histological section (0-4) according to a modified Heath-Edwards classification disclosed that 30 patients had severe "irreversible" PVD (greater than or equal to grade 3) (11 AV septal defect, 8 VSD, 6 TGA + VSD and 5 others); 8 patients were younger than 1 year. Pulmonary vascular resistance (PVR) was calculated in 51 patients and exceeded 7 U/m2 in 1 of 2 patients with grade 0, in 9 of 18 with grade 1, in 1 of 4 with grade 2, in 11 of 18 with grade 3, and in 8 of 9 with grade 4. PVR was also calculated after 100% oxygen administration in 19 patients, 14 of whom had a resting PVR greater than or equal to 7 U/m2. PVR persisted greater than or equal to 7 U/m2 in 5 patients: 4 had PVD greater than or equal to grade 3 and died after surgery. PVR fell to under 7 U/m2 in 14 patients, 3 of whom had PVD greater than or equal to grade 3:1 patient with grade 4 was not operated upon and 2 with grade 3 were operated upon: all are alive. Follow-up in discharged living patients was 100%, with a mean of 50 months. Fifty-five patients underwent surgery with 10 early and 2 late deaths. Among the 12 subjects with a fatal outcome, 10 had irreversible lesions. The 5 non-operated patients all had irreversible lesions at biopsy, and are still alive.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|