Document Detail

Unidirectional monovalve homologous aortic patch for repair of ventricular septal defect with pulmonary hypertension.
MedLine Citation:
PMID:  17532418     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Severe pulmonary hypertension is a common complication of congenital cardiac defects with large left to right shunt, and the closure of a large ventricular septal defect (VSD) with elevated pulmonary vascular resistance (PVR) is associated with significant morbidity and mortality. A unidirectional monovalve homologous aortic patch was designed to close the large VSD with severe pulmonary hypertension in an effort to decrease the morbidity and mortality. METHODS: Twenty-seven patients (mean age, 15.0 +/- 5.6 years) with large VSD with severe pulmonary hypertension (pulmonary vascular resistance, 15.2 +/- 3.8 Wood units) were repaired with a unidirectional monovalve homologous aortic patch. According to body surface area and the preoperative arterial oxygen saturation, the monovalve homologous aortic patches were fenestrated on the aortic wall with a diameter of 4 to 8 mm. RESULTS: Two patients died of pulmonary hypertensive crisis and cardiac arrest postoperatively. All of the survival patients were followed up (5 months to 10 years) and the cardiopulmonary function was well improved with no late death. Obvious opening and closing of the monovalve was detected by early postoperative echocardiography in seven patients. A small amount of right to left shunt was detected in three patients three months after operation, and in two of them the shunt still existed three years after operation. CONCLUSIONS: Closure of a large VSD in patients with severe pulmonary hypertension could be performed with low morbidity and mortality when a unidirectional monovalve homologous aortic patch was used and the long-term result was satisfactory.
Bo Zhang; Shuming Wu; Jiali Liang; Guangfu Zhang; Guanhua Jiang; Min Zhou; Xiangling Li
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  83     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-28     Completed Date:  2007-06-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2176-81     Citation Subset:  AIM; IM    
Department of Cardiovascular Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China.
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MeSH Terms
Aorta / transplantation*
Cardiac Surgical Procedures / methods*
Heart Septal Defects, Ventricular / complications,  surgery*
Hypertension, Pulmonary / complications*
Transplantation, Homologous
Treatment Outcome
Comment In:
Ann Thorac Surg. 2007 Jun;83(6):2181   [PMID:  17532419 ]

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