| Pulmonary atresia with intact ventricular septum: strategy based on right ventricular morphology. | |
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MedLine Citation:
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PMID: 14666014 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Management strategy for pulmonary atresia with intact ventricular septum is controversial. We treated patients with this anomaly according to a management protocol based on our quantitative assessment of right ventricular morphology (index of right ventricular development and right ventricle-tricuspid valve index). In the present study, we reviewed a 20-year experience of the surgical treatment at our institution to define guidelines for selecting the appropriate type of surgical procedure. METHODS: Between April 1981 and June 2002, 45 consecutive patients with pulmonary atresia with intact ventricular septum underwent surgical treatment. Open transpulmonary valvotomy was performed in 27 patients and Blalock-Taussig shunt in 18 patients as the initial palliative procedure. Three patients who underwent a successful transpulmonary valvotomy alone in the neonatal period required no further operation. Definitive repair was performed in 32 patients. Biventricular repair was performed on 19 patients, one and a half ventricular repair in 3, and Fontan-type operation in 10. RESULTS: There were 1 early and 2 late deaths before the definitive operation in patients who underwent transpulmonary valvotomy. Two patients who had coronary artery interruption died 3 months and 13 years after the initial Blalock-Taussig shunt. There were 1 early and 2 late deaths after the definitive operation. Actuarial survival, including noncardiac death, was 91.1% at 5 years after the initial procedure and 81.5% at 10 years. CONCLUSIONS: We treated patients with pulmonary atresia with intact ventricular septum according to a management protocol based on our quantitative assessment of right ventricular morphology with good results. |
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Authors:
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Naoki Yoshimura; Masahiro Yamaguchi; Hidetaka Ohashi; Yoshihiro Oshima; Shigeteru Oka; Masahiro Yoshida; Hirohisa Murakami; Teruo Tei |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 126 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-12-10 Completed Date: 2004-01-14 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1417-26 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiothoracic Surgery, Kobe Children's Hospital, Japan. y-naoki@za2.so-net.ne.jp |
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiac Surgical Procedures
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methods*,
mortality Cohort Studies Female Follow-Up Studies Fontan Procedure / methods, mortality Heart Catheterization / methods* Heart Septum / anatomy & histology* Heart Ventricles / surgery Humans Infant, Newborn Male Palliative Care / methods Pulmonary Atresia / diagnosis*, surgery* Reference Values Reoperation Retrospective Studies Risk Assessment Severity of Illness Index Survival Rate Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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