Document Detail


Muscular infundibular atresia is associated with coronary ostial atresia in pulmonary atresia with intact ventricular septum.
MedLine Citation:
PMID:  21718454     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether infundibular morphology is associated with coronary ostial atresia and/or right ventricle dependent coronary circulation in patients with pulmonary atresia with intact ventricular septum.
DESIGN: Neonatal echocardiograms of patients with pulmonary atresia with intact ventricular septum were evaluated for tricuspid valve size and infundibular anatomy (muscular pulmonary atresia vs. membranous pulmonary atresia). Right ventricle dependent coronary circulation and coronary ostial atresia were diagnosed angiographically. Medical record review determined patient outcome.
SETTING: Tertiary-care pediatric hospital.
RESULTS: Of 72 patients, 24 had muscular pulmonary atresia including 23 with right ventricle dependent coronary circulation. Fourteen of these had unilateral or bilateral coronary ostial atresia. Of 46 patients with membranous pulmonary atresia, 5 five had right ventricle dependent coronary circulation and none had coronary ostial atresia. Muscular pulmonary atresia patients had smaller tricuspid valve z-scores and were less likely to achieve a biventricular repair than those with membranous pulmonary atresia (P < .01). Muscular pulmonary atresia had 82% sensitivity, 98% specificity, and 96% positive predictive value for presence of right ventricle dependent coronary circulation. In the group with membranous pulmonary atresia, there were two deaths, no transplants, and 23 (48%) achieved a biventricular repair. In contrast, of the 24 with muscular pulmonary atresia, there were seven deaths, two transplants, and no biventricular repairs.
CONCLUSIONS: In this cohort, muscular pulmonary atresia was strongly associated with right ventricle dependent coronary circulation and coronary ostial atresia, and appears to be a useful morphologic marker for poor outcome among pulmonary atresia with intact ventricular septum patients. This information may be useful during prenatal counseling and for presurgical evaluation.
Authors:
Alaina K Kipps; Andrew J Powell; Jami C Levine
Related Documents :
12781054 - Graft patency in off-pump and conventional coronary artery bypass grafting for treatmen...
15173734 - Solid and gaseous cerebral microembolization during off-pump, on-pump, and open cardiac...
305984 - Twisting of an aorta-coronary bypass conduit: a complication of coronary surgery.
20012174 - Index of consciousness and bispectral index values are interchangeable during normotens...
17182954 - Pathogenesis of thoracic and abdominal aortic aneurysms.
25485924 - Risk factors for postoperative pulmonary complications: an update of the literature.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-07-01
Journal Detail:
Title:  Congenital heart disease     Volume:  6     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-09-14     Completed Date:  2012-01-13     Revised Date:  2012-01-18    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  444-50     Citation Subset:  IM    
Copyright Information:
© 2011 Copyright the Authors. Congenital Heart Disease © 2011 Wiley Periodicals, Inc.
Affiliation:
Pediatric Division of Cardiology, UCSF Benioff Children's Hospital, and Department of Pediatrics, University of California-San Francisco, 505 Parnassus Avenue, San Francisco,CA 94143, USA. alaina.kipps@ucsf.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple*
Boston
Cardiac Surgical Procedures
Coronary Angiography
Coronary Circulation
Coronary Vessel Anomalies / complications*,  diagnosis,  mortality,  physiopathology,  surgery
Echocardiography
Female
Heart Ventricles / abnormalities*,  physiopathology,  ultrasonography
Humans
Infant, Newborn
Male
Odds Ratio
Pulmonary Atresia / complications*,  diagnosis,  mortality,  physiopathology,  surgery
Retrospective Studies
Treatment Outcome
Tricuspid Valve / ultrasonography
Ventricular Septum* / ultrasonography

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


Previous Document:  Transcatheter Elimination of Left-to-Right Shunts in Infants with Bronchopulmonary Dysplasia Is Feas...
Next Document:  Streptococcus Pneumoniae Causing Mycotic Aneurysm in a Pediatric Patient with Coarctation of the Aor...