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 language | English |
|---|---|
| Pages (from-to) | 313-317 |
| Number of pages | 5 |
| Journal | International Journal of Cardiology |
| Volume | 151 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 15 2011 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - Alternative approach for selected severe pulmonary hypertension of congenital heart defect without initial correction - Palliative surgical treatment
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
PY - 2011/9/15
Y1 - 2011/9/15
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
UR - http://www.scopus.com/inward/record.url?scp=80052768997&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80052768997&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2010.05.067
DO - 10.1016/j.ijcard.2010.05.067
M3 - Article
C2 - 20580107
AN - SCOPUS:80052768997
VL - 151
SP - 313
EP - 317
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -