Postoperative Management of Pulmonary Arterial Hypertension After Surgical Closure of Hypertensive Ventricular Septal Defect in Pediatrics

Rezk, Moataz E; Kasab, Ibrahim M; Abdelgawad, Basem Mofreh; Saleh, Mohammed A; Abdelrahman, Eman G; Elshafie, Mahmoud A

doi:10.21608/zumj.2021.89415.2309

Postoperative Management of Pulmonary Arterial Hypertension After Surgical Closure of Hypertensive Ventricular Septal Defect in Pediatrics

Document Type : Review Articles

Authors

¹ Cardiothoracic surgery department, Faculty of Medicine, Benha University, Benha, Egypt.

² 15 Hasan Mowafi st - hi Elrawda -New benha

³ Cardiothoracic surgery department, Bahtim Hospital, Bahtim, Egypt.

⁴ Pediatrics department, Faculty of Medicine, Benha University, Benha, Egypt.

10.21608/zumj.2021.89415.2309

Abstract

Abstract:
Background: In spite the great improvement in the intensive care management for cases of left to right shunt with pulmonary hypertension and understanding a lot about pathophysiology of pulmonary hypertension and the use of recent medications and methods to prevent and treat its hazards, it still has less satisfactory outcome after closure in comparison to cases with lower pulmonary artery pressure. Our objective was to evaluate the use of selective oral pulmonary vasodilators in the postoperative period in comparison to anti-failure measures alone.
Results: A retrospective study included 120 patients below two years who underwent surgical closure for hypertensive ventricular septal defect. Patients were divided into two groups each consists of 60 patients. In group I patients received anti-failure drugs only and in group II patients received selective pulmonary vasodilators in addition to anti-failure drugs. The preoperative patient data and echo pressure measurements where comparable among both groups with non-significant difference. The time of ventilation, ICU stay, and hospital stay were significantly shorter in group II (p < 0.05). The rates of hypertensive crisis and 30-day mortality were higher in group I but without significant difference (p > 0.05).
Conclusion: Pulmonary antihypertensive drugs have an important role on lowering the pulmonary artery pressure and give better results for surgical closure of ventricular septal defect.

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