Early closure of a large ventricular septal defect before the onset of elevated pulmonary vascular resistance is important. Pulmonary hypertensive events might cause significant morbidity or mortality, even when closure is performed after infancy. Therefore, treatment of pulmonary hypertension after surgery may be the most important issue affecting the prognosis. We describe successful treatment of pulmonary hypertension in a 25-year-old woman after closure of large ventricular septal defect, with inhaled nitric oxide, sildenafil, and bosentan.
NovickWMGurbuzATWatsonDCLazorishinetsVVPerepekaANMalcicI. Double patch closure of ventricular septal defect with increased pulmonary vascular resistance. Ann Thorac Surg1998; 66: 1533–1538.
2.
ChecchiaPABronickiRAGoldsteinB. Review of inhaled nitric oxide in the pediatric cardiac surgery setting. Pediatr Cardiol2012; 33: 493–505.
3.
ZengWJLuXLXiongCMShanGLLiuZHNiXH. The efficacy and safety of sildenafil in patients with pulmonary arterial hypertension associated with the different types of congenital heart disease. Clin Cardiol2011; 34: 513–518.
4.
PortaNFSteinhornRH. Pulmonary vasodilator therapy in the NICU: inhaled nitric oxide, sildenafil, and other pulmonary vasodilating agents [Review]. Clin Perinatol2012; 39: 149–164.
5.
GiaidAYanagisawaMLanglebenDMichelRPLevyRShennibH. Expression of endothelin-1 in the lungs of patients with pulmonary hypertension. N Engl J Med1993; 328: 1732–1739.
