Document Detail

Pulmonary atresia with intact ventricular septum: is neonatal repair advisable?
MedLine Citation:
PMID:  1708268     Owner:  NLM     Status:  MEDLINE    
The optimal management of pulmonary atresia with an intact ventricular septum in the neonate remains controversial. The introduction of balloon septostomy and prostaglandin has significantly reduced early mortality but early surgical intervention is necessary to obtain a more adequate pulmonary blood flow. Fourteen neonates with pulmonary atresia and an intact ventricular septum were admitted to the Wessex Cardiothoracic Unit, Southampton from 1979 to 1986. Thirteen patients underwent cardiac catheterization. Cardiac catheterization data and right ventricular angiograms were reviewed retrospectively. Four patients with tripartite ventricles underwent total repair. The others received various palliative operations (valvotomy + modified Blalock-Taussig shunt or modified Blalock-Taussig shunt alone). Retrospective analysis of the angiograms indicated that right ventricular morphology alone is not a satisfactory criterion for surgical management. We have been able to demonstrate that there is a good correlation between the diameter of the tricuspid valve and the diameter of the infundibulum and that successful neonatal repair is possible when the tricuspid valve diameter is above 80% of the normal value for weight and when the tricuspid valve diameter to infundibular diameter ratio (TV/Inf ratio) is 2.2 or less. In patients with a tripartite ventricle but inadequate TV diameter and TV/Inf ratio, a closed pulmonary valvotomy with a modified Blalock-Taussig shunt remains the treatment of choice.
A Amodeo; B R Keeton; G R Sutherland; J L Monro
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  5     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1991  
Date Detail:
Created Date:  1991-05-28     Completed Date:  1991-05-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  17-21     Citation Subset:  IM    
Wessex Cardiothoracic Centre, Southampton General Hospital, Southampton, UK.
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MeSH Terms
Follow-Up Studies
Heart Catheterization
Heart Defects, Congenital / surgery*
Heart Septal Defects, Ventricular / surgery
Heart Ventricles / abnormalities
Hemodynamics / physiology
Infant, Newborn
Palliative Care
Postoperative Complications / diagnosis
Pulmonary Valve / abnormalities*,  surgery
Tricuspid Valve / abnormalities

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