%0 Journal Article
%T Does High Altitude Protect Against Irreversible Pulmonary Hypertension?
%A Heath Alexandra
%A Stewart K
%A Mendes J
%A Ramirez M
%J PVRI Review
%D 2010
%I 
%X Aim: To present observations regarding the pulmonary pressure characteristics of children and young adults with congenital heart defects who were born and living in high altitude, before and after correction of the defect. Materials and Method: We analyzed 2 groups of patients. Group 1: 21 patients were diagnosed with clinically significant ventricle septum defects (VSD), measuring an average of 17 mm in its larger diameter (7-35 mm), aged 6.2 years on average (range: 1-23 years), with preoperative New York Heart Association (NYHA) class being an average of 2.1. Their arterial oxygen saturation was 92% on average (82%-99%) and systolic pulmonary pressure (SPP) was 64 mmHg, (range: 22-94 mmHg). Group 2: 60 patients were diagnosed with hemodynamically significant patent ductus arteriosus (PDA), 4.85 mm in its minimum diameter (range: 1.8-13 mm), aged 9.2 years on average (range: 9 months-30 years), in whom the SPP measured preoperatively reached 50.6 mmHg (range: 21-94 mmHg). The intervention involved VSD surgical repair or interventional closure of the PDA. Results: Postinterventional results: Group 1 improved its NYHA functional class to an average of 1.2; the mean oxygen saturation rose to 93% (88%-96%) and the SPP dropped to 36 mmHg (range: 20-61 mmHg). In Group 2, the SPP dropped to an average of 39.8 mmHg (range: 16-79 mmHg). The preoperative SPP to systolic aortic pressure ratio was on average 53.15% (range: 22.58%-96.84%); postoperative, the ratio dropped to 38.39% (16.7%-82%). Conclusions: After intervention, the average SPP invariably dropped in both the groups, although its levels could not be considered normal in all the patients. In addition, the intervention led to clinical improvement. High altitude seems to give this group of patients a protection against irreversible changes in the pulmonary circulation. More prospective, controlled studies and a longer follow-up are needed to confirm this observation.
%K Congenital heart disease
%K high altitude
%K PDA
%K pulmonary hypertension
%K VSD
%U http://www.pvrireview.org/article.asp?issn=0974-6013;year=2010;volume=2;issue=3;spage=131;epage=133;aulast=Heath