Left Ventricular Dilation and Pulmonary Vasodilatation after Surgical Shunt for Treatment of Pre-Sinusoidal Portal Hypertension

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art_SANTAREM_Left_Ventricular_Dilation_and_Pulmonary_Vasodilatation_after_Surgical_2016.PDF (248.44 KB)
Citações na Scopus
2
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article
Data de publicação
2016
Editora
PUBLIC LIBRARY SCIENCE
DOI
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Scopus
Web of Science
PubMed
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Autores
SANTAREM, Orlando Luis de Andrade
BARBATO, Alfonso Julio Guedes
Autor de Grupo de pesquisa
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Citação
PLOS ONE, v.11, n.4, article ID e0154011, 12p, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective The aim of this study was to prospectively investigate the long-term cardiovascular and pulmonary hemodynamic effects of surgical shunt for treatment of portal hypertension (PH) due to Schistosomiasis mansoni. Location The University of Sao Paulo Medical School, Brazil; Public Practice. Methods Hemodynamic evaluation was performed with transesophageal Doppler and contrast-enhanced echocardiography (ECHO) on twenty-eight participants with schistosomal portal hypertension. Participants were divided into two groups according to the surgical procedure used to treat their schistosomal portal hypertension within the last two years: group 1-distal splenorenal shunt (DSRS, n = 13) and group 2-esophagogastric devascularization and splenectomy (EGDS, n = 15). Results The cardiac output (5.08 +/- 0.91 L/min) and systolic volume (60.1 +/- 5.6 ml) were increased (p = 0.001) in the DSRS group. DSRS participants had a significant increase (p < 0.0001) in their left ventricular end-systolic and end-diastolic diameters as well as in their left ventricular end-diastolic and end-systolic volumes (p < 0.001) compared with the preoperative period. No statistically significant difference was found in the patients who underwent EGDS. ECHO revealed intrapulmonary vasodilatation (IPV) in 18 participants (64%), 9 DSRS and 9 EGDS (p > 0.05). Conclusions The late increase in the cardiac output, stroke volume and left ventricular diameters demonstrated left ventricular dilatation after a distal splenorenal shunt. ECHO revealed a greater prevalence for IPV in patients with schistosomiasis than has previously been described in patients with PH from liver cirrhosis.
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https://observatorio.fm.usp.br/handle/OPI/14250
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - ODS/03