[Application of one-way valved patch in treatment of patients with congenital heart disease with severe pulmonary hypertension].
OBJECTIVE
To explore the effect of one-way valved patch used in congenital heart disease with severe pulmonary hypertension.


METHODS
One-way valved patch was used in 30 patients of congenital heart disease with severe pulmonary hypertension (PP/PS > 0.75) in operation. Follow-up of 6 approximately 86 months was conducted to observe its effect.


RESULTS
The pulmonary artery pressure was significantly decreased without trans-patch shunt in 11 cases postoperatively. Trans-patch shunt was determined in 27 cases within postperative 72 hours. There were 2 postoperative deaths out of these 27 patients: one died of low cardiac output syndrome 72 hours after operation, and the other died of right heart failure 4 weeks after operation. Thirty-six patients were restored to health and discharged. Three-month follow-up showed trans-patch shunt in 7 cases, including right-to left shunt in 4 cases and two-side shunt in other 3 cases. Color Doppler ultrasonography conducted 6 months after operation proved trans-patch shunt in 4 cases, right-to-left shunt in 1 case, two-side shunt in 2 cases, and left-to-right shunt in 1 case (PP/PS = 0.45).


CONCLUSIONS
One-way valved patch is useful in selected patients in which postoperative right heart failure can be anticipated so as to shunt the blood in the right heart to the left heart and increase the blood volume in the left heart system to ensure the left heart output and minimize the risk of postoperative right heart failure, at the expense of systemic low oxygen saturation that is, however, well tolerated.
Department of Cardiac Surgery, Qilu Hospital, Shandong University, Jinan 250012, China.
Xin-Yan
XY
Pang
Wei-Hua
WH
Li
Hui-Min
HM
Song
Run-Yi
RY
Su
Jian-Hua
JH
Yu
Yue-Hua
YH
Li
Yan-Wen
YW
Bi
Shou-Xian
SX
Li
D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006343:Heart Septal Defects / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D011665:Pulmonary Valve Insufficiency / Q000209:etiology