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lüll Assessment of pulmonary hypertension in the pediatric catheterization laboratory: current insights from the Magic registry Hill KD; Lim DS; Everett AD; Ivy DD; Moore JDCatheter Cardiovasc Interv 2010[Nov]; 76 (6): 865-73OBJECTIVES: To assess protocols, demographics, and hemodynamics in pediatric patients undergoing catheterization for pulmonary hypertension (PH). BACKGROUND: Pediatric specific data is limited on PH. METHODS: Review of the Mid-Atlantic Group of Interventional Cardiology (MAGIC) collaboration PH registry dataset. RESULTS: Between November 2003 and October 2008, seven institutions submitted data from 177 initial catheterizations in pediatric patients with suspected PH. Pulmonary arterial hypertension associated with congenital heart disease (APAH-CHD) (n = 61, 34%) was more common than idiopathic PAH (IPAH) (n = 36, 20%). IPAH patients were older with higher mean pulmonary arterial pressures (mPAP) (P < 0.01). Oxygen lowered mPAP in patients with IPAH (P < 0.01) and associated PAH not related to congenital heart disease (APAH-non CHD) (P < 0.01). A synergistic effect was seen with inhaled nitric oxide (iNO) (P < 0.01). Overall 9/30 (29%) patients with IPAH and 8/48 (16%) patients with APAH-non CHD were reactive to vasodilator testing. Oxygen lowered pulmonary vascular resistance index (PVRI) in patients with APAH-CHD (P < 0.01). There was no additive effect with iNO but a subset of patients required iNO to lower PVRI below 5 WU.m(2). General anesthesia (GA) lowered systemic arterial pressure (P < 0.01) with no difference between GA and procedural sedation on mPAP or PVRI. Adverse events were rare (n = 7) with no procedural deaths. CONCLUSIONS: Pediatric patients with PH demonstrate a higher incidence of APAH-CHD and neonatal specific disorders compared to adults. Pediatric PH patients may demonstrate baseline mPAP < 40 mm Hg but > 50% systemic illustrating the difficulty in applying adult criteria to children with PH. Catheterization in children with PH is relatively safe.|*Blood Pressure[MESH]|*Cardiac Catheterization/adverse effects[MESH]|Adolescent[MESH]|Analysis of Variance[MESH]|Anesthesia, General/adverse effects[MESH]|Antihypertensive Agents[MESH]|Child[MESH]|Child, Preschool[MESH]|Familial Primary Pulmonary Hypertension[MESH]|Heart Defects, Congenital/*complications/physiopathology[MESH]|Humans[MESH]|Hypertension, Pulmonary/diagnosis/etiology/physiopathology[MESH]|Infant[MESH]|Linear Models[MESH]|Logistic Models[MESH]|Predictive Value of Tests[MESH]|Prospective Studies[MESH]|Pulmonary Artery/*physiopathology[MESH]|Registries[MESH]|Risk Assessment[MESH]|Risk Factors[MESH]|Severity of Illness Index[MESH]|Treatment Outcome[MESH]|United States[MESH]|Vasodilator Agents[MESH] |