Combined approach in ventricular septal defect and adult pulmonary hypertension

Area of Science:

• Cardiology
• Pulmonology
• Adult Congenital Heart Disease

Background:

• Early closure of large ventricular septal defects (VSDs) is critical to prevent elevated pulmonary vascular resistance.
• Pulmonary hypertension can lead to significant morbidity and mortality, even after late VSD closure.

Observation:

• A 25-year-old woman presented with pulmonary hypertension following the surgical closure of a large VSD.
• The patient's condition required intensive management to address the post-surgical pulmonary hypertensive event.

Findings:

• Successful treatment of severe pulmonary hypertension was achieved using a combination of inhaled nitric oxide, sildenafil, and bosentan.
• This multi-drug approach effectively managed the pulmonary hypertensive crisis in the adult patient.

Implications:

• Post-operative pulmonary hypertension management is a key factor influencing prognosis in adult VSD closure patients.
• This case highlights the potential efficacy of inhaled nitric oxide, sildenafil, and bosentan in treating refractory pulmonary hypertension after VSD repair.