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. 1977 Oct;39(10):1093–1101. doi: 10.1136/hrt.39.10.1093

Functional status of patients with large ventricular septal defect and pulmonary vascular disease 6 to 16 years after surgical closure of their defect in childhood.

K A Hallidie-Smith, R S Wilson, A Hart, E Zeidifard
PMCID: PMC483376  PMID: 911561

Abstract

We have reviewed 27 patients now 6 to 16 years after closure of a ventricular septal defect at 3 to 12 years of age associated with pulmonary hypertension with a view to assessing their quality of life, respiratory function, and exercise performance. All the patients led normal unrestricted lives. Their subjective lack of symptoms was, in general, confirmed by the results obtained from assessment of lung function tests and two-stage exercise testing in 19 volunteers. Abnormal ventilation in relation to work load was noted in 5 patients and a slightly low exercise cardiac output in 6. Although the patients led normal lives and had a satisfactory response to exercise, measurement of pulmonary artery pressure showed striking pulmonary hypertension on effort. Despite the satisfactory progress of these patients their more long-term future must be one of conjecture and their residual pulmonary hypertension, indicative of residual pulmonary obstruction, must lend weight to arguments for earlier closure of ventricular septal defect before 1 to 2 years of age when changes in the pulmonary vascular bed may be reversed after closure of the defect.

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Selected References

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  1. BLAKEMORE W. S., FORSTER R. E., MORTON J. W., OGILVIE C. M. A standardized breath holding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide. J Clin Invest. 1957 Jan;36(1 Pt 1):1–17. doi: 10.1172/JCI103402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. DE LEE G. J., MATTHEWS M. B., SHARPEY-SCHAFER E. P. The effect of the Valsalva manoeuver on the systemic and pulmonary arterial pressure in man. Br Heart J. 1954 Jul;16(3):311–316. doi: 10.1136/hrt.16.3.311. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. DUBOIS A. B., BOTELHO S. Y., BEDELL G. N., MARSHALL R., COMROE J. H., Jr A rapid plethysmographic method for measuring thoracic gas volume: a comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects. J Clin Invest. 1956 Mar;35(3):322–326. doi: 10.1172/JCI103281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Denison D., Edwards R. H., Jones G., Pope H. Direct and rebreathing estimates of the O2 and CO2 pressures in mixed venous blood. Respir Physiol. 1969 Oct;7(3):326–334. doi: 10.1016/0034-5687(69)90016-4. [DOI] [PubMed] [Google Scholar]
  5. Godfrey S., Davies C. T., Wozniak E., Barnes C. A. Cardio-respiratory response to exercise in normal children. Clin Sci. 1971 May;40(5):419–431. doi: 10.1042/cs0400419. [DOI] [PubMed] [Google Scholar]
  6. Godfrey S., Wozniak E. R., Courtenay Evans R. J., Samuels C. S. Ear lobe blood samples for blood gas analysis at rest and during exercise. Br J Dis Chest. 1971 Jan;65(1):58–64. [PubMed] [Google Scholar]
  7. Graham T. P., Jr Ventricular performance in patients following corrective surgery for congenital heart disease. Adv Cardiol. 1974;11(00):81–106. doi: 10.1159/000395208. [DOI] [PubMed] [Google Scholar]
  8. HOHORST H. J. Enzymatische Bestimmung von L(+)-Milchsäure. Biochem Z. 1957;328(7):509–521. [PubMed] [Google Scholar]
  9. Hallidie-Smith K. A., Hollman A., Cleland W. P., Bentall H. H., Goodwin J. F. Effects of surgical closure of ventricular septal defects upon pulmonary vascular disease. Br Heart J. 1969 Mar;31(2):246–260. doi: 10.1136/hrt.31.2.246. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hislop A., Haworth S. G., Shinebourne E. A., Reid L. Quantitative structural analysis of pulmonary vessels in isolated ventricular septal defect in infancy. Br Heart J. 1975 Oct;37(10):1014–1021. doi: 10.1136/hrt.37.10.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. JOHNSON A. M. Impaired exercise response and other residua of pulmonary stenosis after valvotomy. Br Heart J. 1962 May;24:375–388. doi: 10.1136/hrt.24.3.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Jones N. L., Campbell E. J., McHardy G. J., Higgs B. E., Clode M. The estimation of carbon dioxide pressure of mixed venous blood during exercise. Clin Sci. 1967 Apr;32(2):311–327. [PubMed] [Google Scholar]
  13. Jonsson B., Lee S. J. Haemodynamic effects of exercise in isolated pulmonary stenosis before and after surgery. Br Heart J. 1968 Jan;30(1):60–66. doi: 10.1136/hrt.30.1.60. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. KIRKLIN J. W., DUSHANE J. W., PATRICK R. T., DONALD D. E., HETZEL P. S., HARSHBARGER H. G., WOOD E. H. Intracardiac surgery with the aid of a mechanical pump-oxygenator system (gibbon type): report of eight cases. Proc Staff Meet Mayo Clin. 1955 May 18;30(10):201–206. [PubMed] [Google Scholar]
  15. Kimball K. G., McIlroy M. B. Pulmonary hypertension in patients with congenital heart disease. Pre- and postoperative hemodynamics, pulmonary function, and criteria for surgical closure of defects. Am J Med. 1966 Dec;41(6):883–897. doi: 10.1016/0002-9343(66)90047-7. [DOI] [PubMed] [Google Scholar]
  16. LILLEHEI C. W., COHEN M., WARDEN H. E., VARCO R. L. The direct-vision intracardiac correction of congenital anomalies by controlled cross circulation; results in thirty-two patients with ventricular septal defects, tetralogy of Fallot, and atrioventricularis communis defects. Surgery. 1955 Jul;38(1):11–29. [PubMed] [Google Scholar]
  17. Lueker R. D., Vogel J. H., Blount S. G., Jr Cardiovascular abnormalities following surgery for left-to-right shunts. Observations in atrial septal defects, ventricular septal defects, and patent ductus arteriosus. Circulation. 1969 Dec;40(6):785–801. doi: 10.1161/01.cir.40.6.785. [DOI] [PubMed] [Google Scholar]
  18. Maron B. J., Redwood D. R., Hirshfeld J. W., Jr, Goldstein R. E., Morrow A. G., Epstein S. E. Postoperative assessment of patients with ventricular septal defect and pulmonary hypertension. Response to intense upright exercise. Circulation. 1973 Oct;48(4):864–874. doi: 10.1161/01.cir.48.4.864. [DOI] [PubMed] [Google Scholar]
  19. McILROY M. B., APTHORP G. H. Pulmonary function in pulmonary hypertension. Br Heart J. 1958 Jul;20(3):397–402. doi: 10.1136/hrt.20.3.397. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. TURINO G. M., BRANDFONBRENER M., FISHMAN A. P. The effect of changes in ventilation and pulmonary blood flow on the diffusing capacity of the lung. J Clin Invest. 1959 Jul;38(7):1186–1201. doi: 10.1172/JCI103894. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Vogel J. H., Grover R. F., Jamieson G., Blount S. G., Jr Long-term physiologic observations in patients with ventricular septal defect and increased pulmonary vascular resistance (with 2 color plates). Adv Cardiol. 1974;11(00):108–122. doi: 10.1159/000395209. [DOI] [PubMed] [Google Scholar]
  22. Wagenvoort C. A., Wagenvoort N. Pathology of the Eisenmenger syndrome and primary pulmonary hypertension. Adv Cardiol. 1974;11(00):123–130. doi: 10.1159/000395210. [DOI] [PubMed] [Google Scholar]
  23. Weidman W. H., DuShane J. W. Course of pulmonary hypertension following surgical closure of ventricular septal defect. Adv Cardiol. 1974;11(00):131–134. doi: 10.1159/000395211. [DOI] [PubMed] [Google Scholar]

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