[Surgical correction of an incomplete endocardial cushion defect in a 66-year-old male with the remarkable pulmonary hypertension]

Abstract

A surgical case of a 66-year-old male with an endocardial cushion defect (ECD) is reported. He had preoperative pulmonary hypertension (80/25 mmHg, Pp/Ps 0.61), hypoxia (63.7 mmHg) and decreased creatinin clearance (45.7 ml/min). Respiratory condition was New York Heart Association's (NYHA's) grade III. Angiocardiography showed a typical gooseneck deformity associated with mitral and tricuspid valve regurgitations with the cleft (Seller's grade II and III). As surgical correction, direct suture of the cleft in an anterior leaflet with mitral annuloplasty, patch closure of the ostium primum defect with Xenomedical patch and tricuspid annuloplasty were performed. Postoperative data were restored to NYHA grade I. decreased pulmonary artery pressure (43/21 mmHg) and resistances (Pp/Ps 0.36). The only three surgical treatments of an incomplete ECD were reviewed in over 65-year-old patients in Japan included one perioperative death. Although we suggest it should be actively taken surgical repair even in elderly patients with pulmonary hypertension.