| Novel surgical approach 'intrapulmonary-artery septation' for Fontan candidates with unilateral pulmonary arterial hypoplasia or pulmonary venous obstruction. | |
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MedLine Citation:
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PMID: 17669796 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Kisaburo Sakamoto; Akio Ikai; Yoshifumi Fujimoto; Noritaka Ota |
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Publication Detail:
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Type: Journal Article Date: 2006-12-04 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 6 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-08-02 Completed Date: 2007-08-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 150-4 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Shizuoka Children's Hospital, 860 Urushiyama, Aoi-ku, Shizuoka, 420-8660 Japan. sakamoto@jun.ncvc.go.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Follow-Up Studies Fontan Procedure* Heart Defects, Congenital / physiopathology, surgery* Humans Infant 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* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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