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Ann Thorac Surg 2001;72:905-906
© 2001 The Society of Thoracic Surgeons

Case report

Reduction in recalcitrant pulmonary hypertension after operation for atrial septal defect

Hitoshi Yamauchi, MDa,b, Shigeo Yamaki, MDa,b, Masahiro Fujii, MDa,b, Hideyuki Iwaki, MDa,b, Shigeo Tanaka, MD, PhDa,b

a Division of Cardiovascular Surgery, Department of Surgery II, Nippon Medical School, Tokyo, Japan
b Department of Cardiology, Katta General Hospital, Shiroishi, Japan

Accepted for publication May 24, 2000.

Address reprint requests to Dr Yamauchi, Division of Cardiovascular Surgery, Department of Surgery II, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
e-mail: yamauchi_hitoshi/surg2{at}nms.ac.jp

We present the case of a patient with atrial septal defect and severe pulmonary hypertension with pulmonary artery peak pressure greater than 110 mm Hg. Open lung biopsy was done prior to the corrective operation, and pathological findings in the small pulmonary arteries included "musculoelastosis" and complete occlusion of 70% of these small arteries and arterioles. The atrial septal defect was closed, and long-term oral prostacyclin therapy was initiated. Pulmonary artery peak pressure decreased to 65 mm Hg 2 years after the operation. This case demonstrates that in a patient with 70% complete occlusion of small pulmonary arteries and arterioles resulting from "musculoelastosis," not only is surgical intervention possible but also pulmonary artery pressure decreases in the long term after operation.


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Robyn Barst
Ann. Thorac. Surg. 2001 72: 906-907. [Extract] [Full Text] [PDF]



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