[Pulmonary hypertensive crisis after open heart surgery]

Abstract

Three patients with pulmonary hypertensive crisis (PHC) after open heart surgery for ventricular septal defect are reported. These patients ranged in age from 2 to 47 months, with Rp from 7.0 to 10.6 U.m2, Pp/Ps from 0.67 to 1.0, and Qp/Qs from 1.6 to 1.79. Intraoperative lung biopsy showed pulmonary vascular obstructive disease of Health-Edwards grade 2 in each patient. Atelectasis or pleural effusion on their chest-XP films was found when PHC occurred. The PHC course of the last case was recorded continuously on ABP, PAP and LAP. Administration of prostaglandin-E1 directly through the pulmonary arterial catheter was effective on PHC. Continuous recording of ABP, PAP and LAP during the episode was useful to differentiate PHC from acute left heart failure and/or acute right heart failure.