Development and Validation of a Nomogram of Persistent Pulmonary Hypertension in Adult Pretricuspid Shunts After Correction

• Published in: Journal of the American Heart Association 2024-05, Vol.13 (9), p.e032412-e032412
• Main Authors: Zhou, Zeming, Gu, Yuanrui, Tian, Lili, Zheng, Hong, Li, Shiguo
• Format: Article
• Language: English
• Subjects: Adult; Arterial Pressure; Cardiac Surgical Procedures - adverse effects; Female; heart defects; Heart Defects, Congenital - complications; Heart Defects, Congenital - mortality; Heart Defects, Congenital - physiopathology; Heart Defects, Congenital - surgery; Humans; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - etiology; Hypertension, Pulmonary - mortality; Hypertension, Pulmonary - physiopathology; Male; Middle Aged; Nomograms; Original Research; predict; Predictive Value of Tests; Pulmonary Artery - physiopathology; pulmonary hypertension; Retrospective Studies; Risk Assessment; Risk Factors; shunts; surgical repair; Treatment Outcome; Vascular Resistance
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.123.032412

Pretricuspid shunts have been associated with poorer survival rates in patients with Eisenmenger syndrome compared with postricuspid shunts and complex lesions. However, the risk stratification for persistent pulmonary hypertension (PH) in this population remains uncertain. We retrospectively enrolled 103 patients with pretricuspid shunts with high total pulmonary resistance >4.5 Wood units (estimated pulmonary vascular resistance ≥3 Wood units). During a mean±SD follow-up of 20.95±24.84 months, 32 patients developed postoperative persistent PH after shunt correction. We identified 3 significant predictors of postoperative persistent PH, including mean pulmonary artery pressure after inhaled oxygen ≥40.5 mm Hg (odds ratio [OR], 7.78 [95% CI, 2.02-30.03];