Document Detail

Novel surgical approach 'intrapulmonary-artery septation' for Fontan candidates with unilateral pulmonary arterial hypoplasia or pulmonary venous obstruction.
MedLine Citation:
PMID:  17669796     Owner:  NLM     Status:  MEDLINE    
It is difficult to manage patients with single ventricular physiology and unbalanced pulmonary arteries. Since 1998, we started a novel approach [Intrapulmonary-artery Septation (IPAS)] to improve the result for those with severe unbalanced pulmonary arteries consisting of a well-grown pulmonary artery and an inadequately-grown pulmonary artery. The inadequately-grown pulmonary artery includes severe pulmonary arterial hypoplasia and pulmonary venous obstruction. This approach is based on the following concepts: (1) A reliable blood source should be secured to recover the inadequately-grown pulmonary artery; (2) Wasteful volume-load should be prevented for the heart; (3) Long stenosis or non-confluence of pulmonary artery should be avoided. IPAS primarily consists of (A) a Glenn shunt; (B) a systemic-pulmonary artery shunt; and (C) a septation-patch. Both (A) and (B) are adjoined on a well-grown pulmonary artery, and (C) is placed between (A) and (B). PAS brings two separate blood flows of a Glenn shunt to the well-grown side and SPS on the inadequately-grown side. IPAS was performed in 20 patients. Seventeen reached the Fontan operation. Eleven underwent postoperative catheterization and seven had acceptable-balanced pulmonary blood flow distribution. IPAS can pilot more complicated cases having severe unbalanced pulmonary arteries to the Fontan circulation.
Kisaburo Sakamoto; Akio Ikai; Yoshifumi Fujimoto; Noritaka Ota
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Publication Detail:
Type:  Journal Article     Date:  2006-12-04
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  6     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-08-02     Completed Date:  2007-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  150-4     Citation Subset:  IM    
Department of Cardiovascular Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660 Japan.
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MeSH Terms
Child, Preschool
Follow-Up Studies
Fontan Procedure*
Heart Defects, Congenital / physiopathology,  surgery*
Patient Selection*
Pulmonary Artery / abnormalities,  physiopathology,  surgery*
Pulmonary Circulation
Pulmonary Veins / abnormalities*,  physiopathology
Pulmonary Veno-Occlusive Disease / physiopathology,  surgery*
Time Factors
Treatment Outcome
Vascular Surgical Procedures*

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