Alternative approach for selected severe pulmonary hypertension of congenital heart defect without initial correction - Palliative surgical treatment

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

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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 ± 9 years) received PAB as a palliative procedure in the past 8 years without mortality. The pre-PAB systolic pulmonary pressure was 119 ± 9 mmHg. 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 ± 9.2 mmHg to 42.0 ± 9.0 mmHg) and 6-minute walk test was also found to have great improvement (270 ± 86 m to 414 ± 49 m), but the saturation at rest did not show a difference. Three of them received corrective surgery to close defects over 3-5 years. 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.

Original languageEnglish
Pages (from-to)313-317
Number of pages5
JournalInternational Journal of Cardiology
Volume151
Issue number3
DOIs
Publication statusPublished - Sep 15 2011
Externally publishedYes

Fingerprint

Congenital Heart Defects
Palliative Care
Pulmonary Hypertension
Pulmonary Artery
Blood Pressure
Lung
Arteries
Pressure
Ventricular Heart Septal Defects
Catheterization
Mortality

Keywords

  • Congenital heart defect
  • Left-to-right shunt
  • Pulmonary hypertension
  • Ventricular septal defect

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Alternative approach for selected severe pulmonary hypertension of congenital heart defect without initial correction - Palliative surgical treatment. / Lin, Ming Tai; Chen, Yih Sharng; Huang, Shu Chien; Chiu, Hsin Hui; Chiu, Shuenn Nan; Chen, Chun An; Wu, En Ting; Chiu, Ing Sh; Chang, Chung I.; Wu, Mei Hwan; Wang, Jou Kou.

In: International Journal of Cardiology, Vol. 151, No. 3, 15.09.2011, p. 313-317.

Research output: Contribution to journalArticle

Lin, Ming Tai ; Chen, Yih Sharng ; Huang, Shu Chien ; Chiu, Hsin Hui ; Chiu, Shuenn Nan ; Chen, Chun An ; Wu, En Ting ; Chiu, Ing Sh ; Chang, Chung I. ; Wu, Mei Hwan ; Wang, Jou Kou. / Alternative approach for selected severe pulmonary hypertension of congenital heart defect without initial correction - Palliative surgical treatment. In: International Journal of Cardiology. 2011 ; Vol. 151, No. 3. pp. 313-317.
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abstract = "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 ± 9 years) received PAB as a palliative procedure in the past 8 years without mortality. The pre-PAB systolic pulmonary pressure was 119 ± 9 mmHg. 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 ± 9.2 mmHg to 42.0 ± 9.0 mmHg) and 6-minute walk test was also found to have great improvement (270 ± 86 m to 414 ± 49 m), but the saturation at rest did not show a difference. Three of them received corrective surgery to close defects over 3-5 years. 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.",
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AU - Lin, Ming Tai

AU - Chen, Yih Sharng

AU - Huang, Shu Chien

AU - Chiu, Hsin Hui

AU - Chiu, Shuenn Nan

AU - Chen, Chun An

AU - Wu, En Ting

AU - Chiu, Ing Sh

AU - Chang, Chung I.

AU - Wu, Mei Hwan

AU - Wang, Jou Kou

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N2 - 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 ± 9 years) received PAB as a palliative procedure in the past 8 years without mortality. The pre-PAB systolic pulmonary pressure was 119 ± 9 mmHg. 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 ± 9.2 mmHg to 42.0 ± 9.0 mmHg) and 6-minute walk test was also found to have great improvement (270 ± 86 m to 414 ± 49 m), but the saturation at rest did not show a difference. Three of them received corrective surgery to close defects over 3-5 years. 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.

AB - 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 ± 9 years) received PAB as a palliative procedure in the past 8 years without mortality. The pre-PAB systolic pulmonary pressure was 119 ± 9 mmHg. 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 ± 9.2 mmHg to 42.0 ± 9.0 mmHg) and 6-minute walk test was also found to have great improvement (270 ± 86 m to 414 ± 49 m), but the saturation at rest did not show a difference. Three of them received corrective surgery to close defects over 3-5 years. 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.

KW - Congenital heart defect

KW - Left-to-right shunt

KW - Pulmonary hypertension

KW - Ventricular septal defect

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