Background: In spite the great improvement in the intensive care
management for cases of left to right shunt with pulmonary hypertension and
understanding a lot about pathophysiology of pulmonary hypertension and
the use of recent medications and methods to prevent and treat its hazards, it
still has less satisfactory outcome after closure in comparison to cases with
lower pulmonary artery pressure. Our objective was to evaluate the use of
selective oral pulmonary vasodilators in the postoperative period in
comparison to anti-failure measures alone.
Results: A retrospective study included 120 patients below two years who underwent
surgical closure for hypertensive ventricular septal defect. Patients were divided into
two groups each consists of 60 patients. In group I patients received anti-failure drugs
only and in group II patients received selective pulmonary vasodilators in addition to
anti-failure drugs. The preoperative patient data and echo pressure measurements
where comparable among both groups with non-significant difference. The time of
ventilation, ICU stay, and hospital stay were significantly shorter in group II (p <
0.05). The rates of hypertensive crisis and 30-day mortality were higher in group I but
without significant difference (p > 0.05).
Conclusion: Pulmonary antihypertensive drugs have an important role on lowering
the pulmonary artery pressure and give better results for surgical closure of
ventricular septal defect.