Midterm postoperative prognosis of patients with severe left heart valvular disease combined with moderate or severe pul
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RESEARCH ARTICLE
Open Access
Midterm postoperative prognosis of patients with severe left heart valvular disease combined with moderate or severe pulmonary hypertension treated with treprostinil Ning Xu1,2†, Shu‑Ting Huang1,2†, Kai‑Peng Sun1,2, Zeng‑Chun Wang1,2, Hua Cao1* and Qiang Chen1,2*
Abstract Background: To investigate the midterm postoperative prognosis of patients with severe left heart valvular disease combined with moderate or severe pulmonary hypertension (PAH) using subcutaneous injection of treprostinil. Methods: A retrospective study was conducted on 61 patients with severe left heart valvular disease combined with moderate or severe PAH who had undergone mechanical mitral and/or aortic valve replacement from April 2018 to October 2018. The patients were divided into the treprostinil group and the conventional treatment group according to whether they received treprostinil. The patients were assessed by SwanGanz catheterization, echocardiography, the 6-min walk test (6-MWT), the Borg dyspnoea score and the SF-36 questionnaire. Results: Compared with the preoperative data, the mPAP measured by SwanGanz catheterization, the results of the 6-MWT and the Borg score were significantly improved in both groups during the 1 year follow-up (P 35 mmHg measured
by SwanGanz catheterization [11]. The age of the patients was older than 18 years, and the doctor’s advice was followed. The exclusion criteria were as follows: 1. the presence of other types of PAH, such as chronic thromboembolic PAH, hypoxia or pulmonary disease-associated PAH, 2. repeat heart surgery, and 3. severe liver or kidney failure, malignant tumour or severe somatic dysfunction. During the preoperative hospitalization period, the patients performed a 6-min walk test (6-MWT) without assistance and scored their level of exertion on the Borg scale. After obtaining consent from the patients, the patients completed the SF-36 questionnaire and were informed of the questionnaire requirements and precautions in the standard language. Illiterate and semi-illiterate patients completed the questionnaire with guidance from their families. After routine preoperative treatment, all the patients received surgical treatment and achieved successful surgery. Based on the patient’s physical condition, financial situation, perioperative treprostinil use, and the patient’s wishes, all the patients were divided into the treprostinil group (group T, N = 21) and conventional treatment group (group C, N = 40) according to whether they received treprostinil after discharge. The basic information of the patients is listed in Table 1. Preoperative consultation with patients and their families about subsequent anti-pulmonary hypertension drug treatment was conducted. Patients in group C only received vasodilators, cardiac drugs and diuretics, and patients in group T received treprostinil infusion via a positive pressure microinjection pump in addition to those treatments described above. The infusion tube was placed
Table 1 General clinical information in bo
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