Table of Contents
ISRN Cardiology
Volume 2013, Article ID 301617, 5 pages
Clinical Study

Left-to-Right Shunt with Congenital Heart Disease: Single Center Experience

1Gazi University Medical Faculty Hospital, Department of Pediatric Cardiology, 06560 Ankara, Turkey
2Dıskapı Children's Hospital Department of Pediatric Cardiology, 06110 Ankara, Turkey

Received 9 May 2013; Accepted 29 May 2013

Academic Editors: W. S. Aronow, W. Bloch, J. Carlquist, S. Fazio, Y. Furukawa, and Z.-M. Zhang

Copyright © 2013 Ayhan Cevik et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. The objective of this study was to determine the frequency of pulmonary arterial hypertension (PAH) in congenital heart disease (CHD) with an isolated, large left-to-right shunt and to indicate the factors in the development of PAH. Methods. The pressure measurements in the cardiac chambers and the calculations based on the Fick’s principle were compared among 3 separate groups of patients, respectively, with PAH, with hyperkinetic pulmonary hypertension (HPH), and with neither PAH nor HPH. Results. PAH was diagnosed in 30 (12.3%) patients, HPH in 35 (14.4%), while 177 (73.1%) were free of either. The highest risk for the development of PAH was found in the presence of perimembranous ventricular septal defect. A statistically significant difference was seen among these groups as to their left atrial pressure ( ) and the mean pulmonary arterial pressure (PAPmean; ). While a correlation was present between RpI on one hand and age on the other ( ), a multiple linear regression could not evidence any correlation among age ( ), gender ( ). Conclusion. Our findings do not allow establishing a correlation between the duration of the high pulmonary flow and pulmonary vascular resistance increase or PAH development in isolated left-to-right shunts with congenital heart diseases.