Surgical outcome of congenital heart defects with pulmonary hypertension in infants

Background: Congenital heart diseases with large left-to-right shunt often have signs of pulmonary artery hypertension. It is an important determinant of morbidity and mortality in patients without educate surgical treatment especially in infants. Methods: Ninety patients with congenital cardiac septal defects and pulmonary arterial hypertension had operation to close their septal defects. All the patients have been checked by Chest X-ray, EchoCG, ECG, selectively performed the cardiac catheterization and lung biopsy. Before and after surgery the PA pressure was compared to systemic by needle puncture measurement. Results: Twenty patients died in the hospital after operation and there were no later deaths in follow-up. Hemodynamic changes after operation included a significant decrease in pulmonary artery pressure (mean pulmonary artery pressure, 28.3± 2.4 mm Hg versus 58.45± 1.69 mm Hg before repair). The follow-up period was from 3 months to 4 years (mean 1.3 +0.6 years). Conclusion: Studies from developed countries have shown that in term infants, young age is not a risk factor for adverse postoperative outcome after surgical closure of septal left-to-right defects. The data presented in this study shows that operations to close cardiac septal defects in the presence of severe pulmonary hypertension are effective, but must be done during first 6 month.