78. Scoliosis surgery normalizes cardiac function in AIS patients

Abstract

BACKGROUND CONTEXT Spinal deformity in asolescent idiopathic scoliosis (AIS) can increase right atrial and ventricular pressures secondary to restrictive lung disease. Pulmonary hypertension leading to cor pulmonale is the most feared outcome. However, mild pulmonary hypertension in AIS patients has been reported in the past. No study has examined these changes including the improvement of right heart function following scoliosis surgery. PURPOSE To determine if scoliosis repair resolves cardiac function abnormalities. STUDY DESIGN/SETTING Retrospective chart review. PATIENT SAMPLE A total of 363 patients: 184 AIS patients undergoing PSF, 179 healthty age-matched controls. OUTCOME MEASURES Cobb angle, 2D-echo signs of structural heart disease, aortic root dimensions, tricuspid regurgitant jet velocity (TRV), PFTs, ABG, and patient demographics reviewed. Right ventricular systolic pressure (RVSP) was estimated using Bernoulli s equation (4[TRV]2) and right atrial pressure. METHODS Retrospective chart review. Group 1: 184 AIS patients, 10-22 years of age, undergoing PSF from 2009-2013 at a single institution. Group 2 control patients: 179 healthy, age-matched adolescents. Cobb angle, 2D-echo signs of structural heart disease, aortic root dimensions, tricuspid regurgitant jet velocity (TRV), PFTs, ABG, and patient demographics reviewed. Right ventricular systolic pressure (RVSP) was estimated using Bernoulli s equation (4[TRV]2) and right atrial pressure. RVSP ≥25 mmHg is a surrogate marker for pulmonary hypertension. All echocardiograms were read by board certified pediatric cardiologists. Group 3: 39 AIS patients from Group 1 with elevated preoperative TRV underwent corrective PSF. Logistic regression was used to assess for differences in TRV between groups. RESULTS Mean preop RVSP was significantly elevated in AIS patients (25.7 vs 17.3; p CONCLUSIONS This study found that 21% of patients with AIS had elevated TRV while age-matched controls had no TRV abnormalities. Additionally, RVSP measurements demonstrated mild pulmonary hypertension in AIS patients. These abnormal values normalized postop, indicating the benefits of scoliosis surgery on cardiac function in AIS. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.