Assessment and follow-up of patients with ventricular septal defect and elevated pulmonary vascular resistance

Neutze, John M.; Ishikawa, Tatsuo; Clarkson, P. M.; Calder, A. Louise; Barratt‐Boyes, B. G.; Kerr, A.

doi:10.1016/0002-9149(89)90340-8

Cited by 59 publications

(21 citation statements)

References 9 publications

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“…In general, positive AVT for borderline cases with posttricuspid shunts is defined as a decrease in PVRI to <6 to 8 WU·m 2 or PVR/SVR ratio <0.3. [107][108][109][110] However, AVT is only 1 measure used to define operability, and the whole clinical picture, the age of the patient, and the type of lesion need to be taken into consideration.…”

Section: Acute Vasoreactivity Testingmentioning

confidence: 99%

“…111,418 Six of 7 children with CHD and baseline PVR >6 U·m 2 and PVR-to-SVR ratio >0.3 who responded to brief iNO inhalation with a decrease in PVR and PVR-to-SVR ratio >10% and an absolute PVR-to-SVR ratio <0.3 survived surgical intervention. 418 Several studies suggest that a PVRI <7 to 8 WU·m 2 in response to a vasodilator challenge predicts a good outcome, 108,411,417,419 although good surgical outcomes can occur with higher PVR in some settings.…”

Section: Operabilitymentioning

confidence: 99%

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Pediatric Pulmonary Hypertension

Abman¹,

Hansmann²,

Archer³

et al. 2015

Circulation

913

405

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Abstract-Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension. This publication presents the results of extensive literature reviews, discussions, and formal scoring of recommendations for the care of children with pulmonary hypertension. Key Words: AHA Scientific Statements ◼ bronchopulmonary dysplasia ◼ congenital diaphragmatic hernia ◼ congenital heart disease ◼ genetics ◼ persistent pulmonary hypertension of the newborn ◼ sickle cell disease © 2015 by the American Heart Association, Inc., and the American Thoracic Society.Circulation is available at http://circ.ahajournals.org DOI: 10.1161/CIR.0000000000000329 †Deceased. The American Heart Association and the American Thoracic Society make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This document was approved by the American Heart Association Science Advisory and Coordinating Committee on May 12, 2015, the American Heart Association Executive Committee on July 22, 2015, and the American Thoracic Society on July 24, 2015.The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIR.0000000000000329/-/DC1. The American Heart Association requests that this document be cited as follows: Abman SH, Hansmann G, Archer SL, Ivy DD, Adatia I, Chung WK, Hanna BD, Rosenzweig EB, Raj JU, Cornfield D, Stenmark KR, Steinhorn R, Thébaud B, Fineman JR, Kuehne T, Feinstein JA, Friedberg MK, Earing M, Barst RJ, Keller RL, Kinsella JP, Mullen M, Deterding R, Kulik T, Mallory G, Humpl T, Wessel DL; on behalf of the American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Clinical Cardiology, Council on Cardiovascular Disease in the Young, Council on Cardiovascular Radiology and Intervention, Council on Cardiovascular Surgery and Anesthesia, and the American Thoracic Society. Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society. Circulation. 2015;132:2037-2099 Copies: This document is available on the World Wide Web site of the American Heart Associat...

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Section: Acute Vasoreactivity Testingmentioning

confidence: 99%

Section: Operabilitymentioning

confidence: 99%

Pediatric Pulmonary Hypertension

Abman¹,

Hansmann²,

Archer³

et al. 2015

Circulation

913

405

View full text Add to dashboard Cite

show abstract

“…Because we did not administer either tolazorine [9] or isoproterenol [10] to our patient to determine the reactivity of the pulmonary arteries, we cannot assign the observed increase in pulmonary vascular resistance as that due to organic changes and that due to functional vasoconstriction.…”

Section: Discussionmentioning

confidence: 99%

A rare case of large ventricular septal defect with minimal pulmonary vascular obstructive changes in a 41-year-old woman

et al. 1995

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We describe a case of large ventricular septal defect (VSD) with minimal obstructive changes in the small pulmonary arteries of a 41-year-old woman. Before cardiac catheterization, some laboratory findings led us to consider that surgical closure of the defect would not be possible. However, because hemodynamic examinations showed only mildly elevated pulmonary vascular resistance, we patch-closed the VSD successfully. The histology of lung specimens showed only minimal obstructive changes in the small pulmonary arteries. Considering the size of the VSD and the age at which we hemodynamically evaluated the patient, the mildness of the pulmonary vascular obstructive changes appeared to be atypical in the natural course of a VSD of this size.

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“…24 The level of PVR that precludes the safe closure of a heart defect varies with the age of the patient, type of lesion, PVR, and the presence of vasoreactivity. 86,[159][160][161] This topic remains a matter of significant controversy and outside the scope of this article.…”

Section: Preventionmentioning

confidence: 98%