title: Clinical and pathologic comparison of simple left-to-right shunt congenital heart disease and transposition of the great arteries with ventricular septal defect.
abstract: BACKGROUND
  This study aimed to compare clinical and pathologic data for selected patients with congenital heart disease (CHD) and severe pulmonary hypertension (PH) treated with a diagnostic-treatment-and-repair strategy and to compare results for patients with pulmonary vascular disease (PVD) with simple left-to-right shunt CHD with patients with transposition of the great arteries (TGA) and ventricular septal defect (VSD).
  
  
  METHODS
  Group I comprised 38 patients with simple left-to-right shunt CHD and severe PH; group II included 11 older patients with TGA with VSD and severe PH; and group III comprised 6 autopsy cases of individuals with a normal circulation. The nature of the pulmonary arteries was determined by the Heath-Edwards classification system. All specimens were quantitatively analyzed.
  
  
  RESULTS
  Group I showed 31 patients with a change to grade I, 3 patients were grade II, 3 patients were grade III, and only 1 patient was grade IV. Group II showed 7 patients with a change to grade I, 2 patients were grade II, 1 patient was grade III, and only 1 patient was grade IV. The media wall thickness percentage (%MT), the media wall area percentage (%MS), and arteriole density were significantly higher in groups I and II than in group III. %MS was significantly higher in group II than in group I; no significant differences in %MT and arteriole density could be found between groups I and II.
  
  
  CONCLUSIONS
  The PVD in these selected patients with CHD and severe PH who were cared for with a diagnostic-treatment-and-repair strategy is generally reversible, and the changes in PVD in the patients with TGA and VSD were similar to those in the patients with simple left-to-right shunt CHD.
authors.affiliation: Department of Cardiothoracic Surgery, The Affiliated Ruikang Hospital of Guangxi Traditional Chinese Medical College, Nanning, China. gz98039@hotmail.com
authors.forename: Jing-bin
authors.initials: JB
authors.lastname: Huang
authors.forename: Jian
authors.initials: J
authors.lastname: Liang
authors.forename: Ming
authors.initials: M
authors.lastname: Du
mesh_terms: D000328:Adult; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures; D014188:Transposition of Great Vessels / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome