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Flap valved closure of ventricular septal defects with increased pulmonary vascular resistance.
MedLine Citation:
PMID:  20724425     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Closure of ventricular septal defect (VSD) in children with elevated pulmonary vascular resistance (PVR) is associated with significant morbidity and mortality with pulmonary hypertensive (PH) episodes being a major postoperative problem. Flap valved closure of VSD is reported to decrease morbidity and mortality. We report our experience of closure of a VSDs in patients with severe PH, using a valved patch in an effort to reduce the risk of operation. Eighteen consecutive patients with a large VSD with severe PH (mean PVR>8 Wood units) underwent flap valved closure (as described by Novick et al.) of VSD during a one-year study period. The mean age at surgery was 8.3±3.9 years (range: 3-13 years). Mean PVRI was 13.02±4.05 Wood units. In-hospital 30-day mortality was 5.6% (1/18). Mechanical ventilation time averaged 11.6±8.1 hours. Postoperative pulmonary artery pressures were significantly reduced. Four patients had PH crisis postoperatively. Obvious opening and closing of the flap valve was detected by echocardiography in eight patients. There were no late deaths due to cardiac causes. Closure of a large VSD in patients with severe pulmonary hypertension could be performed with low morbidity and mortality when a flap valve patch was used.
Authors:
Prasanna Simha Mohan Rao; Varadaraju Raju; Madhusudana Narayana
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Publication Detail:
Type:  Journal Article     Date:  2010-08-19
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  11     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  577-80     Citation Subset:  IM    
Affiliation:
Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bannerghatta Road, Bangalore, India. prasannasimha@gmail.com
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