%0 Journal Article %A K F Hossack %A J C Tewksbury %A L M Reid %T Successful repair of an atrial septal defect associated with right to left shunting. %D 1989 %R 10.1136/hrt.62.1.69 %J British Heart Journal %P 69-73 %V 62 %N 1 %X An atrial septal defect was successfully repaired in a young woman despite the presence of pulmonary hypertension and right to left shunting. Before repair both isoprenaline infusion and 100% inspired oxygen produced significant falls in pulmonary artery pressure and pulmonary vascular resistance. A lung biopsy specimen at operation indicated a considerable decrease in the concentration of parenchymal pulmonary arteries and an absence of intimal fibrosis or medial hypertrophy. Pulmonary artery banding performed in infancy, as part of the management of a ventricular septal defect, may have contributed to the underdevelopment of the pulmonary vascular tree. The reduced number of pulmonary arteries is a possible explanation for the pulmonary hypertension. %U https://heart.bmj.com/content/heartjnl/62/1/69.full.pdf