[Residual pulmonary hypertension after surgical correction of left-right shunts. Therapeutic implications (proceedings)].
Late closure of left to right shunts with pulmonary hypertension may leave residual pulmonary hypertension. To determine the best period for total repair, a large number of factors must be taken into account: --the spontaneous evolution of left to right shunts; --the prognosis or residual pulmonary hypertension after total repair; --the probability of total recovery after surgery of the various types of shunting, related to the age of operation. From these factors, it appears that: --the closure of atrial septal defects (where pulmonary hypertension is never major in the child) can wait till childhood or adolescence; --ductus arteriosus must be repaired before the age of 2 years; --in ventricular septal defects with pulmonary hypertension, the best chance of recovery is secured when surgery is performed between the ages of 1 and 2. Earlier intervention should be considered only if medical therapy is ineffective. After that period, it may leave pulmonary hypertension in being.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001022:Aortic Valve Insufficiency / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000209:etiology; D005260:Female; D006343:Heart Septal Defects / Q000150:complications*; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology*; D007223:Infant; D008297:Male
Hypertension pulmonaire résiduelle après correction chirurgicale des shunts gauche-droite. Implications thérapeutiques.