Double flap patch closure of XXXX with elevated pulmonary vascular resistance: an experience at AFIC/NIHD.

@entity1 @entity1757 @entity120 @entity7855 @entity891 @entity358 @entity551
OBJECTIVE: To determine the 30 days outcome measured in terms of morbidity and mortality in cases of @entity1757 ( @entity1757 ) with @entity358 resistance (PVR) managed with double flap patch closure. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Armed Forces Institute of Cardiology (AFIC/NIHD), Rawalpindi, from December 2005 to December 2008. METHODOLOGY: Forty @entity1 with @entity1757 having PVR 9.58 + 4.33 wood units underwent double flap patch closure. The patch was fenestrated as one half of the expected aortic annulus diameter. A separate flap patch 5 mm larger than fenestration was attached to superior upper one third margins of fenestration. The patch was placed with flap to open towards the left ventricular apex. Modified ultra filtration (MUF) was employed in every case and @entity7855 was given postoperatively. RESULTS: The age of @entity1 ranged from 1 to 28 years with a mean of 6.66 + 5.70 years. There were 22 males and 18 females. All @entity1 were weaned off from inotropic and ventilatory support as earlier as possible postoperatively with intensive care unit (ICU) stay of 77.15 + 54.56 hours. @entity891 were reduced to 42.63 + 10.86 mmHg as compared to pre-operative pulmonary artery pressures of 88.3 + 15.2 mmHg. Postoperatively 11 @entity1 with @entity551 and desaturation went into @entity120 in which immediate 2D echo evidenced the functioning flap valve with right to left shunt. There was only one death (early) out of 40 @entity1 with an overall mortality of 2.5% along with limited morbidity. CONCLUSION: Double flap patch is an inexpensive, easy to construct technique with low morbidity and mortality in cases of @entity1757 with raised PVR.
