RESUMO
Background: Unrepaired truncus arteriosus (TA) carries poor prognosis due to complications of unrestricted pulmonary flow, truncal valve insufficiency, and pulmonary vascular disease. Currently, the hemodynamic profile of adults late after TA repair is unknown. We reviewed the hemodynamics, prevalence, and pathophysiology of pulmonary hypertension (PH) in this population. Methods: Eighteen adult patients with repaired TA who underwent cardiac catheterization at Mayo Clinic, MN, between 1997 and 2021 were identified. PH was defined as either precapillary (mean pulmonary artery pressure [mPAP] ≥25â
mmâ
Hg, pulmonary artery wedge pressure [PAWP] ≤15â
mmâ
Hg, and pulmonary vascular resistance [PVR] >3 Wood units), isolated postcapillary (mPAP ≥25, PAWP >15, PVR ≤3), or combined (mPAP ≥25, PAWP >15, and PVR >3). Diastolic pressure and transpulmonary gradients were used as ancillary data for classification. Results: Mean age at catheterization was 34 ± 10 years. Mean right ventricular (RV) systolic pressure was 82 ± 22.6â
mmâ
Hg, mean right and left mPAPs 28.1 ± 16.2 and 27.9 ± 11.9â
mmâ
Hg, respectively. Seven patients (41.2%) had PAWP >15â
mmâ
Hg and, among those undergoing arterial catheterization, 7 (53.8%) had a left ventricular (LV) end-diastolic pressure >15â
mmâ
Hg. PH was diagnosed in 13 patients (72.2%): 6 (33.3%) precapillary, 4 (22.2%) isolated postcapillary, and 3 (16.7%) combined. PAWP >15â
mmâ
Hg was associated with male sex (P = .049), Assuntos
Hipertensão Pulmonar
, Persistência do Tronco Arterial
, Adulto
, Humanos
, Masculino
, Adulto Jovem
, Tronco Arterial
, Pressão Propulsora Pulmonar/fisiologia
, Hemodinâmica
, Hipertensão Pulmonar/etiologia
, Hipertensão Pulmonar/cirurgia
, Hipertensão Pulmonar/diagnóstico
, Resistência Vascular/fisiologia
, Cateterismo Cardíaco/efeitos adversos
, Persistência do Tronco Arterial/cirurgia
, Persistência do Tronco Arterial/complicações