Effects of Pulmonary Hemodynamics on Lung Function in Adlu Patients With Atrial Septal Defect

Yoshioka, Toshimasa; Kunieda, Takeyoshi; Naito, Masahiro; Fukunaga, Yasuo; Okubo, Shumpei; Nakanishi, Norifumi

doi:10.1253/jcj.49.960

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…The most prominent abnormalities are lung volume restriction1-5 and changes in residual volume and functional residual capacity 25 6Normal3 7 8 or decreased airway patency2 5 6 is found. Non-uniform changes in lung elasticity also occur 2…”

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confidence: 99%

Pulmonary function in children with atrial septal defect before and after heart surgery

Šulc

Andrle²,

Hruda³

et al. 1998

Heart

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Objective-To test the eVect of heart disease and heart surgery on lung function. Design-A pulmonary function study of children undergoing surgery for atrial septal defect (ASD). Settings-University hospital. Patients-26 children tested before surgery (at mean (SD) age 11.8 (3.8) years) and 24 patients tested 1.8 (0.2) years after surgical correction. Methods-Lung volumes, lung elasticity, and airway patency indices were measured using standard techniques. Results-Before surgery: pulmonary function test abnormalities were found in 18 of the 26 patients. StiV lung was found in 12, lung hyperinflation in five, and indices of decreased airway patency in four. Total lung capacity decreased in only two patients. After surgery: pulmonary function test abnormalities were found in 12 of the 24 patients (informed consent not given for two patients). StiV lung was detected in nine and indices of peripheral airway obstruction in four. Mean values of specific airway conductance and peak expiratory flow were all normal. Lung hyperinflation was found only in one of 24 patients. No correlation between perioperative events and pulmonary function test data was found. Conclusions-Pulmonary function test abnormalities persist in half the patients almost two years after surgery for ASD. A decrease in the total frequency of pulmonary function test abnormalities (in 19% of the patients), with a decrease in stiV lung in 8% and lung hyperinflation in 15%, was not significant. Impairment of lung function related to ASD is associated with the disease itself rather than the surgical procedure. (Heart 1998;80:484-488)

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confidence: 99%

Pulmonary function in children with atrial septal defect before and after heart surgery

Šulc

Andrle²,

Hruda³

et al. 1998

Heart

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“…This result means that an element of airflow obstruction in the central and peripheral airway was observed at baseline, consistent with previous studies. 8,11,13,29 The peripheral airway obstruction persisted even after transcatheter closure of ASD. The limitation of peripheral airway airflow may be due to increased pulmonary blood flow, engorged capillary network, or abnormalities in the elastic properties of the lung.…”

Section: Discussionmentioning

confidence: 99%

“…2 Pathologic pulmonary hemodynamics prenatally and postnatally lead to abnormalities in lung structure, 3 and these changes result in pulmonary function abnormalities. Despite a large spectrum of changes in pulmonary function test (PFT) parameters have been reported in patients with ASD, [4][5][6][7][8][9][10][11] the results of these studies are conflicting. The most prominent pulmonary abnormality is lung volume restriction.…”

Section: Introductionmentioning

confidence: 99%

“…The most prominent pulmonary abnormality is lung volume restriction. 7,[10][11][12] Some authors report changes in residual volume, functional residual capacity, 10,11,13 and non-uniform changes in lung elasticity. 9,10,14,15 On the other hand, other studies demonstrate normal or decreased airway patency.…”

Section: Introductionmentioning

confidence: 99%

“…9,10,14,15 On the other hand, other studies demonstrate normal or decreased airway patency. 4,5,7,8,10,11 Closure of the interatrial defect is the treatment of choice for ASD with significant pulmonary to systemic flow ratio, even if the patient has few or no symptoms. 16 Surgical repair of an ASD is a widely accepted low-risk procedure, 17 but carries with it risk of morbidity, discomfort, and thoracotomy scar.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary function changes in children after transcatheter closure of atrial septal defect

Lee

Jeng

Tsao

et al. 2009

Pediatric Pulmonology

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This study was performed to assess changes in pulmonary function test (PFT) and pulmonary outcome after transcatheter closure of atrial septal defect (ASD) in pediatric patients. A total 55 pediatric patients undergoing transcatheter ASD closure received PFT at baseline (day before ASD closure), and at 3 days and 6 months after procedure. Forced vital capacity (FVC), forced expired volume in 1 sec (FEV(1)), FEV(1) to FVC ratio (FEV(1)/FVC), peak expiratory flow (PEF), and mean forced expiratory flow during the middle half of FVC (FEF(25-75)) were measured. Individually, subjects were classified by spirometry as normal, obstructive or restrictive, to evaluate the effect of transcatheter closure on pulmonary outcome. These 55 children had significantly reduced mean PEF and FEF(25-75) (84 +/- 24%, P = 0.040 and 76 +/- 22%, P = 0.010, respectively) at baseline, with FEF(25-75) reduced significantly at 3 days and 6 months (78 +/- 24%, P = 0.010 and 81 +/- 24%, P = 0.040, respectively) after transcatheter closure. Six months after transcatheter closure of ASD, significant improvement was observed in mean FVC (94 +/- 19% vs. 98 +/- 15%, P = 0.034) and FEV(1) (90 +/- 20% vs. 96 +/- 19%, P = 0.008). Assessed individually, better pulmonary outcome was found in patients without pulmonary hypertension (PH) (chi(2) = 8.333, P = 0.044). PFT disturbance was observed in significant flow limitation in the peripheral airway of ASD patients. Improved PFT was found after transcatheter closure and better pulmonary outcome was observed in patients without PH. ASD children need monitoring pulmonary function and should receive transcatheter closure before PH develops.

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Pulmonary Function in Children After Surgical and Percutaneous Closure of Atrial Septal Defect

et al. 2010

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This study aimed to study differences in lung function after surgical and percutaneous atrial septal defect (ASD) closure. Several studies have demonstrated abnormalities of pulmonary function in adults and children with ASD. These abnormalities persist even a few years after correction. This study compared pulmonary function between patients who underwent ASD closure by surgery and those who had closure by device. This is the ideal pediatric population for studying changes in lung function caused by cardiopulmonary bypass or sternotomy. The 46 patients in this study were treated by percutaneous closure (group 1) or surgical closure (group 2) of ASD and then scheduled for pulmonary function testing an average of 5.8 years after ASD closure. The mean values of functional residual capacity, total lung capacity, and residual volume did not differ between the two groups. The surgical group showed a significant decrease in expiratory reserve volume (p < 0.04) and forced vital capacity (p < 0.03). Expiratory flow at 25, 50, and 75% of forced vital capacity did not differ between the two groups but was on the lower limit of normal in both groups. Percutaneous closure of ASD can minimize the side effects of surgical closure on lung function. Longitudinal lung function follow-up assessment after cardiac surgery is warranted to detect and measure restrictive abnormalities in this type of congenital heart disease and others.

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Effects of Pulmonary Hemodynamics on Lung Function in Adlu Patients With Atrial Septal Defect

Cited by 8 publications

References 17 publications

Pulmonary function in children with atrial septal defect before and after heart surgery

Pulmonary function in children with atrial septal defect before and after heart surgery

Pulmonary function changes in children after transcatheter closure of atrial septal defect

Pulmonary Function in Children After Surgical and Percutaneous Closure of Atrial Septal Defect

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