Application of treprostinil in patients with congenital heart disease and severe pulmonary arterial hypertension at plateau section

  AIM  To investigate the safety and effectiveness of continuous intravenous injection of treprostinil in peri-operative period in treatment of pediatric congenital heart disease (CHD) with severe pulmonary arterial hypertension (S-PAH) at high altitude areas.

  METHODS  Thirty three children with CHD and S-PAH admitted to our hospital from January 2017 to October 2018 were selected as experimental group who were treated with treprostinilin in addition to regular oral sildenafil treatment, and other 33 patients admitted from January 2015 to October 2016 were selected as control group who were treated with only oral sildenafil and without treprostinil. Baseline data, echocardiography and BNP at admission and discharge were observed and evaluated in each group.

  RESULTS  There was no significant difference between the two groups in baseline data and ultrasonic indexes. The pulmonary artery systolic pressure (PASP) and peripheral oxygen saturation decreased significantly at the time of discharge in patients in both groups. The PASP in experimental group was significantly lower than that in control group (P<0.05), but there was no significant difference between the two groups in peripheral oxygen saturation. Compared with those in control group, the time of cardiopulmonary bypass, the time of ventilation and the time of ICU stay in experimental group were significantly lower (P<0.05), but no significant difference in the time of aortic occlusion was observed between the two groups. The difference of CI and BNP between the two groups at the time of discharge and operation was statistical significant (P<0.05). Moreover, the difference of BNP and CI between experimental group and control group was significant at the time of discharge, but there was no significant difference in EF value between the two groups.

  CONCLUSION  Continuous intravenous injection of treprostinil in CHD children with S-PAH at high altitude areas may control pulmonary arterial hypertension safely and effectively and effectively reduce the period of ventilation and hospitalization.