For a retrospective chart review at a single location with a minimum 2-years follow-up. Researchers wanted to determine how common pulmonary hypertension is in adolescent idiopathic scoliosis patients and how scoliosis surgery affects pulmonary hypertension. Due to restrictive lung disease, spinal deformity in adolescent idiopathic scoliosis can raise right atrial and ventricular pressures. Although minor pulmonary hypertension in adolescent idiopathic scoliosis (AIS) patients has been observed, the most feared result is pulmonary hypertension leading to cor pulmonale. There had never been an outline that looked at how right heart function improves after scoliosis surgery. The Cobb angle, 2D-echo structural heart disease symptoms, aortic root dimensions, tricuspid regurgitant jet velocity (TRV), pulmonary function tests (PFTs), arterial blood gas (ABG), and patient demographics were also examined. Bernoulli equation (4[TRV]2) and right atrial pressure were used to calculate right ventricular systolic pressure (RVSP). An RVSP of greater than or equal to 36 mmHg is used to proxy pulmonary hypertension. Board-certified pediatric cardiologists read all of the echocardiograms. TRV differences between groups were assessed using logistic regression. In AIS patients, the mean preoperative RVSP was substantially higher (26.9±0.49; P<0.001) than in controls (17.25+0.88). Only 47 (21%) of Group 1 patients showed a high preoperative TRV (≥2.8 m/s) compared to none of the Group 2 patients (P<0.001). AIS patients also had a 3.29 odds ratio for higher TRV (P=0.007), an indirect indicator of pulmonary hypertension, according to logistic regression. The cardiac function of all Group 3 patients improved postoperatively (mean TRV=2.09+0.23; P<0.001). Cobb angle, aortic root parameters, and pulmonary function tests did not correlate. TRV anomalies were observed in 13.9% of patients with adolescent idiopathic scoliosis in this investigation but not in controls. In addition, RVSP tests in AIS patients revealed mild pulmonary hypertension. These aberrant values improved after surgery, demonstrating that scoliosis surgery improves heart function in adolescent idiopathic scoliosis patients.

 

Link:journals.lww.com/spinejournal/Abstract/2021/11010/Scoliosis_Surgery_Normalizes_Cardiac_Function_in.11.aspx

 

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