This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by MARON, B. J. Articles by EPSTEIN, S. E. Search for Related Content PubMed PubMed Citation Articles by MARON, B. J. Articles by EPSTEIN, S. E.

(Circulation. 1973;48:864.)
© 1973 American Heart Association, Inc.

---

Postoperative Assessment of Patients with Ventricular Septal Defect and Pulmonary Hypertension

Response to Intense Upright Exercise

BARRY J. MARON M.D.¹; DAVID R. REDWOOD M.D.¹; JOHN W. HIRSHFELD JR. M.D.¹; ROBERT E. GOLDSTEIN M.D.¹; AMDREW G. MORROW M.D.¹; STEPHEN E. EPSTEIN M.D.¹

¹ From the Cardiology Branch and Clinic of Surgery, National Heart and Lung Institute, Bethesda, Maryland.

Circulatory function of patients with operatively closed ventricular septal defect and preoperative pulmonary arterial hypertension was evaluated in 11 asymptomatic subjects at rest and during intense treadmill exercise three to 15 years after operation. The pulmonary-to-systemic resistance ratio was normal or mildly to moderately elevated preoperatively. Postoperative mean pulmonary arterial pressure at the time of study was normal or mildly elevated at rest in 10 patients and moderately elevated in one (40 mm Hg). During intense upright exercise sufficient to lower pulmonary arterial oxygen saturation to 30%, cardiac output was below the normal range in five patients. Each of these patients had been operated upon after 10 years of age. The magnitude of the postoperative abnormality in cardiac output response to exercise was directly related to age at operation. Two of the five patients with impaired cardiac output response and two other patients manifested an abnormally elevated mean pulmonary arterial pressure during intense exercise. There was a positive correlation between pulmonary arterial pressure during intense exercise and age at operation. These results indicate that late postoperative cardiovascular function may be abnormal in patients with ventricular septal defect and preoperative pulmonary arterial hypertension, and that these abnormalities appear to be related to age at operation. Since all patients were asymptomatic, the long-term clinical significance of these hemodynamic abnormalities remains to be determined.

Key Words: Cardiac catheterization • Cardiac output • Cardiac function

Submitted on April 27, 1973
Accepted on June 11, 1973

This article has been cited by other articles:

				S. Ikawa, Y. Shimazaki, S. Nakano, J. Kobayashi, H. Matsuda, and Y. Kawashima Pulmonary vascular resistance during exercise late after repair of large ventricular septal defectsRelation to age at the time of repair J. Thorac. Cardiovasc. Surg., June 1, 1995; 109(6): 1218 - 1224. [Abstract] [Full Text]