Document Detail


Alternative approach for selected severe pulmonary hypertension of congenital heart defect without initial correction - Palliative surgical treatment.
MedLine Citation:
PMID:  20580107     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: Uncorrected congenital heart defects (CHD) with severe pulmonary hypertension (sPH, systolic pulmonary artery>70% of systolic pressure) are usually considered inoperable. We are curious to know if some selected patients might benefit from palliative operation for those sPH with uncorrected CHD.
METHODS: Adults or adolescents with sPH associated with ventricular septal defect (VSD) with/without great artery anomalies were selected for pulmonary artery banding (PAB) to reduce sPH. The target pulmonary pressure was less than half of the systolic blood pressure after arch or great arteries reconstruction. Repeated catheterization was performed to evaluate the feasibility of defect closure.
RESULTS: Consecutively, 8 patients (age 26±9years) received PAB as a palliative procedure in the past 8years without mortality. The pre-PAB systolic pulmonary pressure was 119±9mmHg. Additional PAB had been applied in 4 of them. All patients showed significant improvement in function class (III to I or II). The mean post-PAB pulmonary pressure decreased significantly (77.5±9.2mmHg to 42.0±9.0mmHg) and 6-minute walk test was also found to have great improvement (270±86m to 414±49m), but the saturation at rest did not show a difference. Three of them received corrective surgery to close defects over 3-5years.
CONCLUSION: For some selected adult sPH with uncorrected CHD, PAB can work as a palliative procedure to improve their functional class and even provide a chance of total repair.
Authors:
Ming-Tai Lin; Yih-Sharng Chen; Shu-Chien Huang; Hsin-Hui Chiu; Shuenn-Nan Chiu; Chun-An Chen; En-Ting Wu; Ing-Sh Chiu; Chung-I Chang; Mei-Hwan Wu; Jou-Kou Wang
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Publication Detail:
Type:  Journal Article     Date:  2010-07-01
Journal Detail:
Title:  International journal of cardiology     Volume:  151     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  313-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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