[Diagnosis and surgical treatment of 102 cases of ventricular septal defect with patent ductus arteriosus].
OBJECTIVE
To summarize the experience of diagnosis and surgical treatment of ventricular septal defect with patent ductus arteriosus.


METHODS
We retrospectively analyzed the clinical data of 102 cases of ventricular septal defect combined with patent ductus arteriosus who underwent surgical treatment. Preoperative ultrasonic cardiogram (UCG) showed ventricular septal defect combined with patent ductus arteriosus in 82 cases and ventricular septal defect in 20 cases.


RESULTS
The hospital mortality was 4.9% (5/102). The reasons for death included low cardiac output syndrome (1 case), pulmonary hypertension crisis (2 cases) and respiratory failure (2 cases). In the remaining patients,the perioperative complications included lung infection (7 cases), pulmonary atelectasis (5 cases), hydrothorax (1 case), and pulmonary hypertension crisis (2 cases); and all the 15 patients recovered lastly. The pulmonary hypertension of all living patients decreased to some degree. The therapeutical effectiveness was satisfactory.


CONCLUSIONS
Ventricular septal defect with patent ductus arteriosus is easy to be confused with ventricular septal defect clinically. At the same time,it is diffcult to form a correct diagnosis in some patients by UCG preoperatively. To prevent the occurrence of perfusive lung, it is important to reinforce preoperative diagnosis and exploration during operation. Because pulmonary hypertension in patients with ventricular septal defect with patent ductus arteriosus emerges early and develops quickly, it tends to result in organic pulmonary hypertension which can make patients lose operation chances and influence the long-term therapeutical effect. Surgical operation should be performed as soon as possible. Optimal operative timing and proper perioperative management play important roles in surgical results.
Gong
Qi-hua
QH
Department of Thoracic and Cardiovascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China. CCGZCS1@yahoo.com.cn
Yang
Yi-feng
YF
Hu
Jian-guo
JG
Yin
Bang-liang
BL
Zhao
Tian-li
TL
Wu
Zhong-shi
ZS
Yang
Jin-fu
JF
D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies