title: Critical decision of operability in congenital heart disease patient with severe pulmonary hypertension.
abstract: Repair of congenital heart disease in the presence of high pulmonary pressure has always been a contentious issue. Pulmonary vascular resistance (PVR) is considered important for establishing operability in these patients. However, PVR estimation is not always accurate and cannot solely be relied upon to make critical decision of operability. Clinical examination, chest X-ray, and echocardiography are also important indicators of pulmonary vascular disease. Knowledge of pits and falls of each investigation is important for appropriate management in these patients. We present a case report of successfully operated, 6-year-old child with anomalous origin of the right pulmonary artery from aorta, deemed inoperable on the basis of PVR estimation.
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Raja
authors.initials: R
authors.lastname: Joshi
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Rajat
authors.initials: R
authors.lastname: Kalra
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Aggarwal
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Reena K
authors.initials: RK
authors.lastname: Joshi
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Mridul
authors.initials: M
authors.lastname: Aggarwal
authors.affiliation: Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Pandey
mesh_terms: D002648:Child; D000066491:Clinical Decision-Making; D004452:Echocardiography; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000601:surgery*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000503:physiopathology; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D014655:Vascular Resistance / Q000502:physiology