Unidirectional valved patch for congenital heart disease with severe pulmonary hypertension.
10.3969/j.issn.1672-7347.2011.11.011
- Author:
Ming WU
1
;
Jinfu YANG
;
Yifeng YANG
;
Jianguo HU
;
Xinmin ZHOU
;
Feng LIU
;
Zhongshi WU
;
Tianli ZHAO
;
Lian XIONG
;
Xin WANG
;
Ni YIN
Author Information
1. Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Cardiac Surgical Procedures;
methods;
Child;
Female;
Heart Defects, Congenital;
complications;
surgery;
Heart Septal Defects, Ventricular;
complications;
surgery;
Humans;
Hypertension, Pulmonary;
etiology;
surgery;
Male;
Pericardium;
transplantation;
Prosthesis Implantation;
Retrospective Studies;
Young Adult
- From:
Journal of Central South University(Medical Sciences)
2011;36(11):1097-1101
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the effect of unidirectional valved patch (UVP) for congenital heart disease (CHD) with severe pulmonary hypertension (PH).
METHODS:We retrospectively analyzed the treatment of 37 CHD patients with severe PH by UVP in the operation, and summarized its short-term to mid-term effect to find an optimum therapeutic regimen.
RESULTS:Before the operation, the ECG showed that the mean pulmonary artery pressure (MPAP) ranged 65-72 mmHg, and the cardiac catheterization showed the pulmonary artery pressure ranged 80-120 mmHg, P(P)/P(A) ranged 0.8-1.05,PVR ranged 8.5-19.2 (under oxygen inhalation 6.8-14.6) wood unit.After the operation, P(P)/P(A) ranged 0.4-0.72 on weaning-off CPB. Postoperative ECG showed the MPAP ranged 32-48 mmHg. No pulmonary hypertension crisis occurred and no patient died. Mechanical ventilation time ranged from 32 h to 8 d and the SaO₂ ranged 93%-96% at rest after the extubation.The right-to-left shunt situations by ECG were as follows:22 cases had shunt 5 d after the operation, 11 cases had shunt 1 month after the operation,4 cases 3 months after the operation, and none 1 year after the operation but one patient lost follow-up.However,there were no long-term follow-up data: 12 patients had a 1-year follow-up, 5 patients had a 3-year follow-up, and most patients had just 3-month follow-up.
CONCLUSION:UVP can decrease the operative risk in CHD with severe PH at perioperative period. The short-term to mid-term effect is satisfactory, while long-term effect remains uncertain.
