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Evaluation of Latent Pulmonary Arterial Hypertension in Congenital Shunt Lesions

U

Universitaire Ziekenhuizen KU Leuven

Status

Completed

Conditions

Atrial Septal Defects
Ventricular Septal Defects

Treatments

Other: No intervention was applied, because it is an observational study

Study type

Observational

Funder types

Other

Identifiers

Details and patient eligibility

About

Prospective, monocentric study for the evaluation of latent pulmonary arterial hypertension in patients with congenital shunt lesions lost to follow-up. Lost to follow-up is defined as latest clinical control ≥ 5 years.

Full description

Pulmonary arterial hypertension (PAH) in patients with congenital heart disease (CHD) usually develops secondary to chronic volume overload of the pulmonary circulation following left to right shunt. This overload leads to elevated pulmonary artery pressure (PAP) and later to increased pulmonary vascular resistance (PVR). This causes pressure overload in the right heart, and thereby right ventricular (RV) and right atrial (RA) dysfunction, which may implicate considerable morbidity and even mortality. Since PAH nowadays is mostly detected when symptoms occur and PAP are elevated, the disease already evolved to an advanced (partially irreversible) stage and treatment is often initiated too late.

Dismissal from follow-up after a surgical correction of simple CHD was customized in the seventies and eighties. There is no literature available that learns us whether these patients really need follow-up or not. A substantial number must have insidiously developed PAH or mild pulmonary vascular disease (PVD) and still are prone to develop PAH later in life. It is relevant to recall these patients dismissed from follow-up in the past, because they might carry a lot of useful information on the natural history of PAH development. Focus will lie mainly on patients with simple shunt lesions, as atrial septal defect (ASD) and ventricular septal defect (VSD).

Enrollment

93 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Previous repair for secundum ASD, VSD

Exclusion criteria

  • Other congenital heart disease
  • Chronic lung disease or total lung capacity < 80% of predicted value
  • History of pulmonary embolism

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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