Combined perventricular closure of ventricular septal defect and atrial septal defect via lower ministernotomy

We report a rare case of unrepaired Tetralogy_Pantalogy of Fallot (TOF_POF) in a 20 years old Persian girl Mrs Zeynab S., who presented with cyanotic finger tops appearance, ongoing chronic thrombolytic destruction processes, and remarkable thrombocytopenia [1,2], heart ventricular septal defect (VSD), and might atrial septal defect (ASD), anxiety, sleep disorders, nightmares, and limited social life. Additionally, the relationship between underlying mechanisms, possible treatments of the thrombocytopenia, erythrocytosis, and unrepaired cardiovascular leakages remains unknown.

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Comparative efficacy of sildenafil in Eisenmenger's syndrome secondary to atrial septal defect versus ventricular septal defect: a cardiac catheterisation follow-up study

Cardiology in the Young ◽

10.1017/s1047951111000497 ◽

2011 ◽

Vol 21 (6) ◽

pp. 631-638 ◽

Cited By ~ 9

Author(s):

Naveen Garg ◽

Nishant Tripathy ◽

Nakul Sinha

Keyword(s):

Ventricular Septal Defect ◽

Atrial Septal Defect ◽

Vascular Resistance ◽

Septal Defect ◽

Functional Class ◽

Cardiac Catheterisation ◽

Haemodynamic Parameters ◽

Mean Pulmonary Arterial Pressure ◽

Eisenmenger’S Syndrome ◽

Minute Walk

AbstractObjectivesThis study evaluates the efficacy and safety of sildenafil in patients with Eisenmenger's syndrome with special emphasis on haemodynamic parameters and its comparative efficacy in atrial septal defect versus ventricular septal defect patients.MethodsOral sildenafil was given to 22 patients with Eisenmenger's syndrome – eight with atrial septal defect and 14 with ventricular septal defect – after detailed baseline evaluation including a six-minute walk test, echocardiography, and cardiac catheterisation. Patients were followed up for a period of 6 months for functional class assessment and six-minute walk distance. Cardiac catheterisation was repeated in all patients.ResultsA significant improvement in the World Health Organization functional class, six-minute walk distance, mean pulmonary arterial pressure, and pulmonary vascular resistance was noticed. Systemic arterial and mixed venous oxygen saturations were also significantly improved along with improvement in pulmonary blood flow. None showed any significant side effects or worsening of systemic arterial saturation. At baseline, mean pulmonary arterial pressure, pulmonary vascular resistance, and pulmonary/systemic vascular resistance ratios were significantly higher in ventricular septal defect patients than in atrial septal defect patients. Atrial septal defect patients showed better response in clinical as well as haemodynamic parameters.ConclusionsSildenafil is an effective and safe agent for patients with Eisenmenger's syndrome. It improves their functional capacity as well as haemodynamic parameters. The beneficial effects are greater in patients with Eisenmenger's syndrome secondary to atrial septal defect than ventricular septal defect.

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