Journal of Cardiology and Heart Failure

ABSTRACT

Background

The assessment of operability in children with non-restrictive left to right shunt lesions presenting with severe pulmonary arterial hypertension (PAH) typically relies on pulmonary vascular resistance index (PVRI). However, pulmonary artery compliance (Cp) remains underutilized.

Objectives

This study aimed to describe Cp values in this population, evaluate their relationship with conventional hemodynamic parameters, and establish cut-off values for Cp in basal and oxygen studies.

Methods

This was a single-center retrospective analysis done in children with non-restrictive left to right shunt lesions with severe PAH, who underwent cardiac catheterization from March 2018 to August 2025. Patients with basal PVRI more than 6 wuxm2 were included in the study. The cohort was divided into two groups, group A - patients who were operated and group B – patients who were managed medically. The Cp was calculated retrospectively in both the groups.

Results

A total of 63 patients were included in this analysis. Group A had significantly higher basal Cp values compared to Group B (mean basal Cp: 1.12 ±0.47 vs. 0.66 ±0.16 ml/mmHg/m², p < 0.01). Cp showed strong positive correlation with indexed pulmonary blood flow and strong negative correlation with PVRI.

Conclusion

This study provides normative Cp values and thresholds in children with severe PAH due to non-restrictive VSD or PDA. Cp correlated strongly with conventional hemodynamic indices, and the identified cut-off values may serve as useful reference points. However, prospective outcome-based studies are required to clarify its role in surgical decision-making.

Keywords: Pulmonary Artery Hypertension; Pulmonary Artery Compliance; Ventricular Septal Defect; Patent Ductus Arteriosus; Oximetry Analysis; Pulmonary Vascular Resistance Index