[Changes in intracardiac hemodynamics during of the natural course of isolated stenoses of pulmonary artery and the right ventricular outflow tract].

AIM: To study alterations in intracardiac hemodynamics in patients with isolated stenosis of the pulmonary artery (ISPA) and right ventricular outflow tract (RVOT).

MATERIAL AND

METHODS

The disease course was studied by means of repeated probing of the heart chambers, angiocardiography and echocardiography in 32 patients with ISPA and RVOT. Follow-up was performed for 14 years (mean 44.3 +/- 7.47 months).

RESULTS

ISPA and RVOT run differently in adults and children. In initial gradient of systolic pressure (GSP) between the right ventricle (RV) and pulmonary artery (PA) under 25 mmHg, its rise with time in the adults is insignificant while in patients with marked stenosis especially in children GSP elevates greatly. Natural course of ISPA and RVOT depends also on the type of obstruction and the degree of hemodynamic disorders. In isolated valvular PA stenosis if systolic overload of RV is absent, the disease course is favourable and expectation policy is possible. In valvular-infundibular stenosis of RVOT compensating ability of the RV depletes quicker and therefore urgent operation is required.

CONCLUSION

Congenital ISPA and RVOT are progressive diseases natural course of which depends on the type of obstruction, severity of hemodynamic disorders and age of the patients.