Đánh giá kết quả phẫu thuật vá thông liên thất tăng áp lực động mạch phổi rất nặng ở trẻ lớn và người lớn tại trung tâm tim mạch bệnh viên E

Objective: Evaluate the short and medium results of 46 consecutive infands and adults who had ventricular septum defect (VSD) with severe pulmonary hypertention had been operated in Cardiovascular Center - E Hospital. Material and methods: Retro and prospective study of all patients having VSD with severe pulmonary hypertension operated in Cardiovascular Center, E Hospital from March 2010 to December 2012. Results: Of those, there are 22 males, 24 female, the average age is 14.1 + or - 1.5 (ranging from 44 to 3 year old). The predominant dinical signs are recurrence pneumonitis (39/46 - 83,7 percent), delays in height and weight (loo percent), pectus carinatum (chicken breast 41/46 - 89,1 percent). The other dinical signs indicated a severe stage of this disease induding; recurrence heamotasis, membrance and skind discoloment, scoliokyphosis, especially inaudible typical VSD systolic murmur (39/46). The Echocardiography (46 pts) and angiography (37/46 pts) preoperation show a severe pulmonary hypertention; mean 98,5 + or - 2,4 (135-73), and 100,7 + or - 3,6 (150 - 67), Rp/Rs 0,58 + or - 0,05 (1,26 - 0,21). All patients were operated on standard opened heart surgery, normothermia and warm blood cardioplasia. The VSD was dosed via right artiotomy and atrial septotomie was done if it's necessary. The majority of these patients had been extubated 24 hours postoperation. Tree of Six early dearth related with pulmonary hypertension. Bilateral lung biopsy had done in 30/46 (65 percent) patients, of those 22/30 pulmonary vascular lesions in stage 2-3, 7 in stage 2 and 1 in satge 4. 40 patients were discharged from Hospital in good condiction. 34/40 patients were reexaminated, the average follow up is 10,2 + or - 1,2 months (ranging 01 - 26 months) with dearly ameliorational clinical status. Conclusion; The results of VSD closed with pulmonary hypertention in E Hospital are acceptable.. The mortality and morbidity related with VDS-pulmonary hypertention can be preventive and decreased. There is a mismatch between the clinical, paraclinical exploration with lung biopsy, so the research on diagnosis and management of this disease in attitude is needed. This opens the opportunity to treat a number of patients with previous concept is not just for surgery.