Progress in Evaluation of Patients with Left to Right Shunt Congenital Heart Disease and Pulmonary Hypertension

Left to right shunt congenital heart disease results in a consistent increase of blood in pulmonary vascular bed,thus leading to the constriction and remodeling of pulmonary vasculature and an increased pulmonary pressure,which may affect the surgical effect of patients.At early stage,pulmonary vascular disease is still reversible,which guarantees a good prognosis of patients.However,when the pulmonary vascular disease becomes severe,surgical treatment can not benefit patients and may even lead to a higher mortality.The severity and reversibility of pulmonary vasculature is not correlated with the pulmonary resistance or the pulmonary pressure.How to select patients for surgeries remains a clinical controversy confronted with many doctors.This review will provides the latest progress in basic and clinical researches to determine the operative indications for selecting patients with pulmonary hypertension associated with congenital heart disease for surgical treatment.