World J Pediatr Congenit Heart Surg. 2026 May 28:21501351261434210. doi: 10.1177/21501351261434210. Online ahead of print.
ABSTRACT
BackgroundThis study analyzed the utility of the pulmonary artery flow study (PAFS) in prognostic assessment for children with pulmonary atresia and ventricular septal defect (PA/VSD).MethodsWe reviewed 121 patients with type B or C pulmonary atresia and ventricular septal defect (PA/VSD) who underwent the PAFS between August 2016 and August 2024. Demographic, operative, and follow-up data were collected. Statistical analyses included Spearman's correlation, ROC curves, and Kaplan-Meier survival analysis.ResultsThe cohort included 60 males and 61 females, with 97 type B and 24 type C cases. Mean age was 44 months and median weight was 12.8 kg. Mean pulmonary artery pressure (mPAP) strongly correlated with postoperative right ventricular systolic pressure/left ventricular systolic pressure (RVSP/LVSP) (P = 0.000). An mPAP cutoff of 24.5 mmHg predicted VSD closure with 79.2% sensitivity and 91.2% specificity. Mean pulmonary artery pressure and RVSP/LVSP were associated with prolonged ventilation and critical care unit stay. During follow-up, 15/121 children (12.4%) died, with significantly poorer survival in those with mPAP > 25 mmHg (P = 0.009).ConclusionsThe pulmonary artery flow study is a valuable predictor of successful VSD closure and postoperative outcomes. An mPAP threshold of 25 mmHg may help identify high-risk patients requiring more intensive management.
PMID:42207036 | DOI:10.1177/21501351261434210