Indications for open lung biopsy in patients with ventricular septal defect and/or patent ductus arteriosus with pulmonary hypertension.

In a previous paper, it was stated that open lung biopsy for determination of operative indications could be recommended if pulmonary vascular resistance (PVR) were higher than 8 units.m2 in patients with ventricular septal defect (VSD) and/or patent ductus arteriosus (PDA) with severe pulmonary hypertension. In the present study, oxygen inhalation or Tolazoline administration tests with or without occlusion of ductus arteriosus were performed during cardiac catheterization in 47 patients with VSD and/or PDA with severe pulmonary hypertension. The results obtained were compared with the operability based on our histopathological diagnostic criteria. There was no correlation between the oxygen, Tolazoline, or ductus occlusion hemodynamics and the baseline hemodynamics for better prediction of the biopsy should be performed for the determination of operative indication when patients with VSD and/or PDA have a PVR higher than 8 units.m2, and if the PVR is greater than 4 units.m2 with the oxygen inhalation test or 7 units.m2 with the Tolazoline test.