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  • Title: [Residual pulmonary hypertension after surgical correction of left-right shunts. Therapeutic implications (proceedings)].
    Author: Vernant P.
    Journal: Schweiz Med Wochenschr; 1977 Nov 05; 107(44):1547-51. PubMed ID: 918608.
    Abstract:
    Late closure of left to right shunts with pulmonary hypertension may leave residual pulmonary hypertension. To determine the best period for total repair, a large number of factors must be taken into account: --the spontaneous evolution of left to right shunts; --the prognosis or residual pulmonary hypertension after total repair; --the probability of total recovery after surgery of the various types of shunting, related to the age of operation. From these factors, it appears that: --the closure of atrial septal defects (where pulmonary hypertension is never major in the child) can wait till childhood or adolescence; --ductus arteriosus must be repaired before the age of 2 years; --in ventricular septal defects with pulmonary hypertension, the best chance of recovery is secured when surgery is performed between the ages of 1 and 2. Earlier intervention should be considered only if medical therapy is ineffective. After that period, it may leave pulmonary hypertension in being.
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