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Pulmonary Hypertension is a frequent disease in third level hospitals, with elevated morbidity and mortality in short time. To choose the medical treatment is fundamental to do a pulmonary vasoreactivity test.
To show and classify the results of the vasoreactivity test in the different groups of pulmonary Hypertension, done by basilar and radial Access.
Material and Method
By consecutive simple we captured cases in which left and right catheterism is done in patients with pulmonary hypertension, since November 2010 to January 2012. By basilar access we did the right catheterism, oximetries and pressure are registered, in superior vena cava, Inferior vena cava, Right Ventricle and Pulmonary Trunk. By radial Access pressures and oximetries are registered in aorta and Left Ventricle. Cardiac output is determined by Fick Method. The vasoreactivity was evaluated with adenosine infusion in the pulmonary trunk, in doses of 100 mcg/kg/min with a maximum of 12 mgs. A positive test is considered when Mean Pulmonary arterial pressure (mPAP) decrease more than 10 mmHg or a (mPAP) less than 40 mmHg without affection of the cardiac output.
92 procedures were done, 57% women, mean age 44 years, 58 patients of the group 1, 22 of the group 2, 7 of the group 3 and 5 of the group 4. Only 8% of the patients responded to adenosine infusion, 6 patients from the group 1 and 1 patient from de group 3 (Pulmonary Hypertension classification, Dana Point 2008). The mPAP decreased on average of 17 mmHg, and it was sustained in average 7.2 minutes. All procedures were done successfully and same day discharge. Complications: 2 patients referred severe chest pain with the adenosine infusion, but not persistent electrocardiographic abnormalities are founded. 10% of patients presented pain in the Access site that was controlled with analgesics.
Basilar and radial Access was accepted in 100% percent of the patients, and all are same day discharged. There were no major complications and the vasoreactivity test was positive only in 8% of the patients, principally patients of the group 1.
- 2013 American College of Cardiology Foundation