Document Detail


Ascending aortic extension for right pulmonary artery stenosis associated with ventricular-to-pulmonary artery conduit replacement.
MedLine Citation:
PMID:  9690496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Ventricular-to-pulmonary artery conduits in growing patients with congenital heart disease will require replacement from time to time due to somatic growth, neointimal hyperplasia, and pulmonary artery stenosis. The purpose of this article is to review our experience with ascending aortic extension for significant long-segment pulmonary artery stenosis in patients undergoing reoperation for right ventricular-to-pulmonary artery conduit replacement. METHODS: From 1989 to 1997, 8 patients had aortic transection, right pulmonary artery augmentation arterioplasty, and aortic interposition graft (Hemashield in 7 and Gore-tex in 1) in association with right ventricular-to-pulmonary artery conduit replacement in 7 patients and completion Fontan operation in 1 patient. Aortic cross-clamp time was 90 +/- 34 minutes, and the cardiopulmonary bypass time was 205 +/- 37 minutes. RESULTS: All patients survived. In those 7 patients who had conduit replacement, the RV/LV ratio declined from 0.78 +/- 0.15 to 0.45 +/- 0.05 postoperatively (P < 0.05). Average length of stay was 8.9 +/- 7.2 days. Follow-up range is 18 months to 8 years (mean 4 years). Two complications included cardiac transplantation for pre-existing poor left ventricular function and accelerated conduit stenosis leading to conduit re-replacement. CONCLUSION: Ascending aortic extension facilitates long-segment pulmonary artery augmentation arterioplasty and enlarges the retroaortic space, preventing future compression restenosis.
Authors:
R D Curran; C Mavroudis; C L Backer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  12     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    1997 Nov-Dec
Date Detail:
Created Date:  1998-09-28     Completed Date:  1998-09-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  372-9; discussion 380     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular and Thoracic Surgery, Children's Memorial Hospital, Northwestern University Medical School, Chicago, Illinois 60614, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aorta / surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / methods
Cardiovascular Surgical Procedures / methods*
Child
Child, Preschool
Female
Heart Defects, Congenital / surgery
Humans
Infant
Male
Pulmonary Artery / abnormalities*,  surgery*
Pulmonary Valve Stenosis / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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