Successful repair of an atrial septal defect associated with right to left shunting.
An atrial septal defect was successfully repaired in a young woman despite the presence of pulmonary hypertension and right to left shunting. Before repair both isoprenaline infusion and 100% inspired oxygen produced significant falls in pulmonary artery pressure and pulmonary vascular resistance. A lung biopsy specimen at operation indicated a considerable decrease in the concentration of parenchymal pulmonary arteries and an absence of intimal fibrosis or medial hypertrophy. Pulmonary artery banding performed in infancy, as part of the management of a ventricular septal defect, may have contributed to the underdevelopment of the pulmonary vascular tree. The reduced number of pulmonary arteries is a possible explanation for the pulmonary hypertension.
Hossack
K F
KF
Department of Medicine, University of Colorado Health Sciences Center, Denver 80204.
Tewksbury
J C
JC
Reid
L M
LM
D000328:Adult; D006328:Cardiac Catheterization; D003326:Coronary Circulation; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology / Q000601:surgery*