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

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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

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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

Lin, M. T., Chen, Y. S., Huang, S. C., Chiu, H. H., Chiu, S. N., Chen, C. A., Wu, E. T., Chiu, I. S., Chang, C. I., Wu, M. H., & Wang, J. K. (2011). Alternative approach for selected severe pulmonary hypertension of congenital heart defect without initial correction - Palliative surgical treatment. International Journal of Cardiology, 151(3), 313-317. https://doi.org/10.1016/j.ijcard.2010.05.067