Pulmonary vascular disease associated with pulmonary hypertension in 445 patients: diagnosis from lung biopsy and autopsy
- Shigeo Yamaki
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Diagnosis from lung biopsy or autopsy was performed in 445 patients with congenital (385) or acquired (60) heart disease from all over Japan. The purpose of this study is the presentation of these prospective data collections.
Of the patients with congenital heart disease, 354 were biopsied to determine whether surgery was indicated. Decisions regarding surgery were based on the index of pulmonary vascular disease in simple cardiac anomalies or atrioventricular septal defects (AVSD). In total anomalous pulmonary venous connection (TAPVC), operative indication was determined by the degree of hypoplasia of small pulmonary arteries. Operability of Fontan procedure was based on the degree of residual medial hypertrophy after pulmonary artery banding.
In patients with simple cardiac anomalies, radical surgery was indicated in 166. Radical surgery was indicated in 50 patients with AVSD. In 26 patients with TAPVC, radical surgery was not indicated in 10. In 68 Fontan candidates, surgery was not indicated in 49. Among 7 patients with tetralogy of Fallot, 1 was not a surgical candidate. Of the 60 acquired heart disease patients, 16 had idiopathic pulmonary arterial hypertension and 36 had chronic thromboembolic pulmonary hypertension. In 6 patients, lung biopsy revealed pulmonary veno-occlusive disease; 2 patients had combined valvular disease.
The cardiac surgeon, pediatric cardiologist, and cardiologist who requested diagnosis from lung biopsy or autopsy were gratified with the results.
- Yamaki S, Ogata H, Haneda K, Mohri H. Indication for lung biopsy in patients with ventricular septal defect and/or patent ductus arteriosus with pulmonary hypertension. Heart Vessels. 1990;5:166–71. CrossRef
- Yamaki S, Tezuka F. Quantitative analysis of pulmonary vascular disease in complete transposition of the great arteries. Circulation. 1976;54:805–8. CrossRef
- Heath D, Edwards JE. The pathology of hypertensive vascular disease: a description of six grades of structural changes in the pulmonary artery with special reference to congenital cardiac septal defects. Circulation. 1958;18:533–48. CrossRef
- Yamaki S, Horiuchi T, Miura M, Haneda K, Ishizawa E, Suzukiet Y. Secundum atrial septal defect with severe pulmonary hypertension: open lung biopsy diagnosis of operative indication. Chest. 1987;91:33–8. CrossRef
- Yamaki S, Mohri H, Haneda K, Endo M. Indication for surgery based on lung biopsy in cases of ventricular septal defect and/or patent ductus arteriosus with severe pulmonary hypertension. Chest. 1989;96:31–9. CrossRef
- Yamaki S, Yasui H, Kado H, Yonenaga K, Nakamura Y, Kikuchi T, et al. Pulmonary vascular disease and operative indication in complete atrioventricular canal defect in infancy. J Thorac Cardiovasc Surg. 1993;106:398–405.
- Yamaki S, Abe A, Tabayashi K, Endo M, Mohri H, Takahashi T. Inoperable pulmonary vascular disease in infant with congenital heart disease. Ann Thorac Surg. 1998;66:1565–70. CrossRef
- Yamaki S, Abe A, Endo M, Tanaka T, Tabayashi K, Takahashi T. Surgical indication for congenital heart disease with extremely thickened media of the small pulmonary arteries. Ann Thorac Surg. 1998;66:1560–648. CrossRef
- Yamaki S, Horiuchi T, Miura M, Suzuki Y, AbeE Ishizawa Y, et al. Musculoelastosis: a change of small pulmonary arteries found in a case with atrial septal defect and pulmonary hypertension. Tohoku J Exp Med. 1985;145:455–63. CrossRef
- Yamaki S, Tsunemoto M, Shimada M, Ishuzawa R, Endo M, Nakayama S, et al. Quantitative analysis of pulmonary vascular disease in total anomalous pulmonary venous correction in sixty infants. J Thorac Cardiovasc Surg. 1992;104:728–35.
- Yamaki S, Ajiki H, Haneda K, Takanashi Y, Ban T, Takahashi T. Pulmonary arterial changes in patients dying after a modified Fontan procedure following pulmonary artery banding. Heart Vessels. 1994;9:263–8. CrossRef
- Yamaki S, Wagenvoort CA. Comparison of primary plexogenic arteriopathy in adults and children. Bri Heart J. 1985;54:428–34. CrossRef
- Ohashi N, Matsushima M, Maeda M, Yamaki S. Two-stage procedure for pulmonary vascular obstructive disease in Down syndrome with congenital heart disease. Circulation J. 2006;70:1446–50. CrossRef
- Maeda K, Yamaki S, Kado H, Asou T, Murakami A, Takamoto S. Hypoplasia of the small pulmonary arteries in hypoplastic left heart syndrome with restrictive atrial septal defect. Circulation. 2004;110(supple):139–46.
- Yamaki S. Pulmonary vascular disease in shunted and nonshunted patients with tetralogy of Fallot. Tohoku J Exp Med. 1990;162:109–19. CrossRef
- Pulmonary vascular disease associated with pulmonary hypertension in 445 patients: diagnosis from lung biopsy and autopsy
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General Thoracic and Cardiovascular Surgery
Volume 61, Issue 1 , pp 24-31
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Pulmonary vascular disease
- Pulmonary hypertension
- Lung biopsy
- Congenital heart disease
- Chronic thromboembolic pulmonary hypertension
- Industry Sectors
- Shigeo Yamaki (1)
- Author Affiliations
- 1. Japanese Research Institute of Pulmonary Vasculature, 40-1 Usagisaku, Shiroishi, Miyagi, 989-0228, Japan