Asian Cardiovasc Thorac Ann 2006;14:501-504
© 2006 Asia Publishing EXchange Ltd
Valved Patch for Ventricular Septal Defect With Pulmonary Arterial Hypertension
Abbas Afrasiabi, MD,
Mahmoud Samadi, MD,
Hossein Montazergaem, MD
Cardiovascular Research Center, Madani Heart Hospital, University of Medical Sciences, Tabriz, Iran
For reprint information contact: Abbas Afrasiabi, MD Tel: 98 411 336 1175 Fax: 98 411 334 4021 Email: aafrasa{at}yahoo.com, Cardiovascular Research Center, Madani Heart Hospital, University of Medical Sciences, Tabriz, Iran.
From March 1998 to December 2004, 16 acyanotic patients aged 2 to 22 years (mean, 7 ± 5.7 years) with a large ventricular septal defect and elevated pulmonary vascular resistance (9.6 ± 3.8 Wood units) underwent surgery. A Gore-Tex patch with a 5–8 mm longitudinal slit in the center was used. A piece of pericardium was sewn around the slit on one side of the patch, except for the upper quarter. In all patients, the defect was closed with a trimmed patch and the pericardial aspect was placed on the left ventricular side to allow right-to-left shunting. Echocardiography on the day of operation revealed a right-to-left shunt in 6 cases. Two patients (12.5%) died in the early postoperative period due to frequent episodes of pulmonary hypertensive crisis and persistent severe pulmonary hypertension. In 3 years of follow-up, pulmonary vascular resistance gradually decreased in all but one patient in whom it increased with a right-to-left shunt and cyanosis. Insertion of a valved patch seems to be a promising technique to decrease morbidity and mortality in severe pulmonary arterial hypertension.
Copyright © 2006 by the Asia Publishing EXchange Ltd.
