Pulmonary vascular disease in neonates with transposition of the great arteries and intact ventricular septum.
AUTOR(ES)
Kumar, A
RESUMO
BACKGROUND--Progressive pulmonary vascular disease in surgically unrepaired transposition of the great arteries with or without ventricular septal defect had been frequently described in the past. Occurrence of progressive pulmonary vascular disease has been reported even after atrial switch procedure done at three months of age. With the advent of neonatal surgical repair, this problem is virtually non-existent. There is a small subgroup of infants with transposition of the great arteries who show pulmonary vascular disease in the neonatal period that can adversely affect the surgical outcome. The clinico-pathological correlation in this group of patients was studied. OBSERVATIONS--Three patients, with transposition of the great arteries and intact ventricular septum, who showed histological evidence of pulmonary vascular disease in the neonatal period or early infancy are described. Two of these patients, continued to have poor systemic oxygenation despite adequate atrial communication. One patient had a close ductus arteriosus within the first two hours of birth while on prostaglandin E1 infusion. CONCLUSIONS--In the absence of left ventricular outflow tract obstruction, a poor response to atrial septostomy suggests pulmonary hypertension and pulmonary vascular disease. Antenatal constriction of the ductus arteriosus may contribute to such changes in pulmonary vasculature.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1025109Documentos Relacionados
- Pulmonary blood flow and left ventricular volumes in transposition of the great arteries and intact ventricular septum.
- Pulmonary atresia and intact ventricular septum and corrected transposition of the great arteries.
- Left ventricular outflow tract obstruction in complete transposition of the great arteries with intact ventricular septum. A cross sectional echocardiography study.
- Intermediate to late term results of Mustard's procedure for complete transposition of the great arteries with an intact ventricular septum.
- Thermal dilution measurement of pulmonary and systemic blood flow in secundum atrial septal defect, and transposition of great arteries with intact interventricular septum.