Valved patch for ventricular septal defect with pulmonary arterial hypertension.
From March 1998 to December 2004, 16 acyanotic patients aged 2 to 22 years (mean, 7 +/- 5.7 years) with a large ventricular septal defect and elevated pulmonary vascular resistance (9.6 +/- 3.8 Wood units) underwent surgery. A Gore-Tex patch with a 5-8 mm longitudinal slit in the center was used. A piece of pericardium was sewn around the slit on one side of the patch, except for the upper quarter. In all patients, the defect was closed with a trimmed patch and the pericardial aspect was placed on the left ventricular side to allow right-to-left shunting. Echocardiography on the day of operation revealed a right-to-left shunt in 6 cases. Two patients (12.5%) died in the early postoperative period due to frequent episodes of pulmonary hypertensive crisis and persistent severe pulmonary hypertension. In 3 years of follow-up, pulmonary vascular resistance gradually decreased in all but one patient in whom it increased with a right-to-left shunt and cyanosis. Insertion of a valved patch seems to be a promising technique to decrease morbidity and mortality in severe pulmonary arterial hypertension.
Afrasiabi
Abbas
A
Cardiovascular Research Center, Madani Heart Hospital, University of Medical Sciences, Tabriz, Iran. aafrasa@yahoo.com
Samadi
Mahmoud
M
Montazergaem
Hossein
H
D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D008297:Male; D010496:Pericardium / Q000637:transplantation; D011138:Polytetrafluoroethylene; D019919:Prosthesis Implantation
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene