Unidirectional valved patch for congenital heart disease with severe pulmonary hypertension / 中南大学学报(医学版)

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 follows22 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.