Valve patch for the treatment of atrial septal defect in patients with severe pulmonary hypertension: A quasi-experimental study

Abstract

Introduction: Atrial septal defect detected in adulthood is associated with pulmonary arterial hypertension. The corrective surgical procedure in these conditions shows increased morbidity and mortality. The use of valve patch prevents the occurrence of early complications.
Objectives: To analyze the behavior of pulmonary pressure, estimated by echocardiography, and right ventricular function, at two years, in patients who underwent valve patch closure of atrial septal defect with severe pulmonary arterial hypertension.
Method: A quasi-experimental study was conducted in patients with atrial septal defect with bad edges and severe pulmonary arterial hypertension. Subjects with evidence of positive reactivity to oxygen or nitric oxide, who gave their informed consent, were included; and patients with genetic syndromes or primary pulmonary arterial hypertension were excluded. Patients were clinically followed up in the immediate postoperative period, through laboratory tests and echocardiography at 2, 4, 6, 12, 18 and 24 months after surgery. And complications were recorded.
Results: There was no early or late death in the 12 patients analyzed. Median mechanical ventilation was 2 (1-4) days. The follow up showed a significant improvement in functional class, echocardiographic variables and medication intake.
Conclusions: Unidirectional valve patch is a therapeutic option that avoids postoperative complications which are the cause of early mortality.