The Effect of Perioperative Administration of Treprostinil in Infants with Non-restrictive Ventricular Septal Defect and
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ORIGINAL ARTICLE
The Effect of Perioperative Administration of Treprostinil in Infants with Non‑restrictive Ventricular Septal Defect and Severe Pulmonary Arterial Hypertension Shu‑Ting Huang1,2 · Ning Xu1,2 · Kai‑Peng Sun1,2 · Liang‑Wan Chen2 · Hua Cao1 · Qiang Chen1,2 Received: 10 April 2020 / Accepted: 23 May 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This study investigated the efficacy and safety of intravenous treprostinil during the perioperative period in infants with non-restrictive ventricular septal defect (VSD) and severe pulmonary arterial hypertension (PAH) undergoing surgical VSD repair. This was a retrospective study. There were 79 infants with non-restrictive VSD and severe PAH receiving surgical treatment from January to December 2019 in our cardiac center. The patients were divided into the treprostinil group and control group according to whether intravenous treprostinil was used during the perioperative period. There were no significant differences in the preoperative characteristics, including age, sex, weight, ventricular size, or preoperative pulmonary artery pressure, between the two groups. Although the pulmonary artery pressure in both groups was significantly lower postoperatively than preoperatively, the postoperative pulmonary artery systolic pressure was significantly lower in group T than in group C. The postoperative mechanical ventilation time, ICU stay, and hospital stay in group T were shorter than those in group C. Treprostinil can be used effectively and safely to reduce the perioperative pulmonary artery pressure in infants with non-restrictive VSD and severe PAH undergoing surgical VSD repair. Keywords Treprostinil · Perioperative administration · Infant · Pulmonary arterial hypertension
Introduction Ventricular septal defects (VSDs) are one of the most common types of congenital heart diseases in infants. For infants with non-restrictive VSDs and severe pulmonary arterial hypertension (PAH), early death from congestive heart failure and severe pulmonary infection will occur if no timely and effective treatment is implemented [1, 2]. These patients have a large left-to-right shunt, resulting in corresponding PAH. Early surgical VSD repair can block this abnormal shunt, reverse pulmonary hypertension and achieve good Shu-Ting Huang and Ning Xu have contributed equally to this study and share first authorship. * Qiang Chen [email protected] 1
Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
2
clinical results [3–7]. Severe PAH may affect the prognosis of patients receiving surgical repair under cardiopulmonary bypass (CPB). Reducing pulmonary artery pressure is beneficial for the management of perioperative anesthesia and postoperative recovery [8–10]. As a long-term, stable prostacyclin analog, treprostinil is useful for the treatment of
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