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Reverse Remodeling of Pulmonary Arterioles After Pulmonary Artery Banding in Patients ≥ 2 Years Old with Severe Pulmonary Arterial Hypertension and Congenital Heart Disease

  • Chenghu Liu
  • Pei Cheng
  • Aijun Liu
  • Bin Li
  • Yao Yang
  • Zhiyi Wang
  • Junwu SuEmail author
Original Article
  • 101 Downloads

Abstract

The purpose of this study was to evaluate the pathological changes of the pulmonary arterioles in patients ≥ 2 years of age who first underwent a pulmonary artery banding (PAB) procedure, followed by bidirectional Glenn or Fontan according to their specific conditions. This was a prospective study of 15 children diagnosed and treated with PAB at the Department of Cardiothoracic Surgery of Anzhen Hospital between January 2009 and December 2012. The percentage of media area (%MS) of pulmonary arteriole, the percentage of media thickness (%MT), and pulmonary arterial density (APSC) were calculated from lung tissue sections. Pulmonary artery pressure decreased significantly after PAB surgery (P < 0.01). Postoperative mean pulmonary artery pressure declined significantly (P < 0.01), the cardiothoracic ratio was reduced (P < 0.05), and percutaneous oxygen saturation (inhaled air) decreased to 80–85% (P < 0.01). %MT (from 35.1 ± 5.6% to 26.9 ± 4.3%, P < 0.01), %MS (from 51.4 ± 6.7% to 32.2 ± 7.4%, P < 0.01), and APSC (from 108.3 ± 38.5 to 83.6 ± 19.6, P < 0.01) were decreased significantly after PAB. Five patients underwent the bidirectional Glenn procedure and four underwent Fontan. In conclusion, the results suggest that PAB can reduce pulmonary artery pressure and that pulmonary arterial lesions can be reversed after PAB.

Keywords

Pulmonary artery banding Pulmonary artery Pathological alteration Pulmonary arterial hypertension Congenital heart disease 

Notes

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no competing interests.

Research Involving Human Participants

The study was approved by the ethics committee of Anzhen Hospital. Written informed consent was obtained from the legal guardians.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki eclaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Chenghu Liu
    • 1
  • Pei Cheng
    • 1
  • Aijun Liu
    • 1
  • Bin Li
    • 1
  • Yao Yang
    • 1
  • Zhiyi Wang
    • 1
  • Junwu Su
    • 1
    Email author
  1. 1.Department of Pediatric Cardiology, Beijing Anzhen HospitalCapital Medical UniversityBeijingChina

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