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مجله دانشکده پزشکی اصفهان، جلد ۳۲، شماره ۳۰۷، صفحات ۱۸۳۸-۱۸۴۳
عنوان فارسی بیماری مادرزادی قلب همراه با پرفشاری شریان ریوی: جراحی یا درمان دارویی؟
چکیده فارسی مقاله -
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عنوان انگلیسی Congenital Heart Disease with Pulmonary Hypertension; Surgery or Medical Treatment?
چکیده انگلیسی مقاله Pulmonary arterial hypertension (PHA) is a frequent complication of congenital heart disease (CHD), most commonly in systemic-to-pulmonary shunt lesions. In patients with an uncorrected left-to right shunt, PAH will end up to Eisenmenger’s syndrome, which is contraindication of surgery. What about patients with moderate to severe PAH, who do not have criteria of Eisenmenger’s syndrome; immediate cardiac repair is preferred or medical treatment? Heart catheterization and evaluation of pulmonary artery reactivity test or lung biopsy might be helpful to find presence of Eisenmenger’s syndrome. Although these guidelines are not always helpful or possible; look at the following article will show how important this subject is. 192 patient with CHD and PAH were evaluated in 4 groups, Eisenmenger’s syndrome (90 patients), left-to-right shunt with PAH (48 patients), PAH with small defect (10 patients) and PAH after defect correction (44 patients). 1-, 5-, 10-, and 20-year survivals were estimated for each group. Findings showed that patients with history of surgery in presence of PAH had worst outcome; and patients with Eisenmenger’s syndrome and those with PAH-associated left-to-right shunt had best prognosis. One of the reasons of this result is presence of a cardiac defect which allows a pulmonary-to-systemic shunt which can maintain the cardiac output in the end stage of disease. Finally, we present a young girl with history of CHD with PAH. She had been operated several years ago. When admitted, she was in a bad condition, with functional class of IV. Echocardiography showed severe PAH. Treatment of PAH started with specific target PAH drugs immediately, but these treatments were too late and patient expired in the hospital. Finally, we would like to pose the question ”Would not it be better if the patient had not undergone the surgery in the first place?”.
کلیدواژه‌های انگلیسی مقاله Congenital heart disease, Pulmonary hypertension, Treatment
نویسندگان مقاله احمد میردامادی | ahmad mirdamadi
استادیار، گروه قلب، دانشکده ی پزشکی، دانشگاه آزاد اسلامی، واحد نجف آباد، اصفهان، ایران
سازمان اصلی تایید شده: دانشگاه آزاد اسلامی نجف آباد (Islamic azad university of najafabad)

سمیرا اشرفی | samira ashrafi
کارشناس ارشد، آزمایشگاه تحقیقاتی، دانشگاه اصفهان، اصفهان، ایران
سازمان اصلی تایید شده: دانشگاه اصفهان (Isfahan university)

نشانی اینترنتی http://jims.mui.ac.ir/index.php/jims/article/view/3776
فایل مقاله اشکال در دسترسی به فایل - ./files/site1/rds_journals/103/article-103-317876.pdf
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زبان مقاله منتشر شده fa
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