ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Pulmonary vasoreactivity testing with inhaled iloprost in children with pulmonary hypertension related to congenital heart disease
Mehmet Emre Arı, Utku Arman Örün, Selmin Karademir, Senem Özgür, Özben Ceylan, Şeyma Kayalı, Mahmut Keskin, Vehbi Doğan
Department of Pediatric Cardiology, Dr. Sami Ulus Obstetrics and Gynecology, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.10333
Background: This study aims to evaluate the acute hemodynamic effects of inhaled iloprost used to measure pulmonary vasoreactivity in congenital heart diseases with pulmonary hypertension.

Methods: Between October 2005 and October 2012, a total of 51 patients (29 boys, 22 girls; mean age 4.9 years; range 4 months to 16 years) under follow-up with a diagnosis of pulmonary hypertension secondary to congenital heart disease who underwent vasoreactivity test with inhaled iloprost were retrospectively evaluated. Cardiac pressure and oxygen saturation values were obtained before and after iloprost inhalation, while flow ratio, pulmonary and systemic vascular resistances were calculated. A decrease greater than 10% in pulmonary vascular resistance, the mean pulmonary artery pressure, and resistance ratio were considered as positive responses to the vasoreactivity test.

Results: Forty-four patients (86.3%) had ventricular septal defect, atrial septal defect, patent ductus arteriosus, and atrioventricular septal defect, while seven patients (23.7%) had complex heart diseases. Forty-two (82.4%) of the patients had positive vasoreactivity test results. In positive vasoreactivity test patients, the pre- and post-iloprost mean pulmonary artery pressure values were 59.7±13.4 mmHg and 53.3±13.7 mmHg (p<0.05), pulmonary vascular resistance was 12.2±7.6 Wood U/m2 and 6.6±6 Wood U/m2 (p<0.05), resistance ratio was (PVR/SVR) 0.6±0.5 and 0.3±0.3 (p<0.05), pulmonary flow (Qp) was 3.6±3.2 l/min and 7.2±9.6 l/min (p<0.05), flow ratio was (Qp/Qs) 2.3±1.5 and 6±4.8 (p<0.05), arterial oxygen saturation was 83.6% and 94.4% (p<0.05), respectively. None of the patients had any side effects associated with inhaled iloprost.

Conclusion: Inhaled iloprost may be a good option as an effective and safe drug for pulmonary vasoreactivity testing in pediatric patients.

Keywords : Inhaled iloprost; pulmonary hypertension; vasoreactivity testing
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