[Ventricular septal defect with severe pulmonary hypertension: the role of open biopsy in determination of operative indication: a case report].

A 51-year-old man having ventricular septal defect with severe pulmonary hypertension is reported. Operative indication that is denied was finally decided by open lung biopsy. He had pulmonary arterial pressure of 120/42 (70) mmHg. The ratio of pulmonary to systemic systolic pressure was 0.91, the ratio Of pulmonary to systemic flow was 1.26, the ratio of pulmonary to systemic vascular resistance was 0.34, and pulmonary vascular resistance was 14.2 unit x m2. For the reason of difficulty, in determination of operative indication through hemodynamic study, he received open lung biopsy. Histological assessment from biopsy specimen revealed severe occlusive pulmonary vascular disease exhibiting grade IV on the Heath Edwards classification. Open lung biopsy occasionally be selected in case with difficult determination of operative indication in severe pulmonary hypertension is a useful tool.