Closure of Ventricular Septal Defect with Severe Pulmonary Hypertension

Pulmonary hypertensive crisis (PHC) is a significant contributor to the morbidity and mortality of surgery for congenital heart defect In particular, ventricular septal defect with a severe increase in preoperative pulmonary vascular resistance (PVR) has a higher chance of developing pulmonary hypertension intra- and postoperatively Recently, pharmacological treatment, for example inhaled iloprost, has been reported as an effective drug for reducing high pulmonary pressure. In our institute, 12 high risk children were monitored in order to identify postoperative PHC after congenital heart repair Children with PHC were treated with aerosolized iloprost (0.5 mu g/kg). Eight of the 12 children had one or more episodes of PHC, secondary to the pulmonary vasoreactivity All responded to aerosolized iloprost treatment, as demonstrated by a fall in their mean pulmonary pressure Advances in pharmacological therapy have given more opportunities for the high risk patients to undergo surgery In medical the setting with limited access to nitric oxide, inhaled iloprost is an effective alternative treatment for postoperative PHC in children undergoing congenital heart surgery