Pulmonary hypertension associated with postoperative tetralogy of fallot

Pulmonary hypertension (PH) is a frequent complication in patients with congenital heart disease (CHD), before or after cardiac surgery. According to the recent clinical classification, PH associated with CHD is categorized into subclasses depending on the pathogenesis: (1) Eisenmenger syndrome, (2) left-to-right shunts, (3) PH with coincidental CHD, and (4) postoperative PH [1]. Postoperative PH means that CHD was repaired, but PH either persists immediately after surgery or recurs/develops months or years after surgery, in the absence of significant postoperative hemodynamic lesions. The anatomical features are varied and the clinical phenotype is often aggressive [2-4].