Document Detail


Pulmonary atresia with intact ventricular septum: is neonatal repair advisable?
MedLine Citation:
PMID:  1708268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A Amodeo; B R Keeton; G R Sutherland; J L Monro
Related Documents :
2709868 - Tricuspid valve avulsion or excision for right ventricular decompression in pulmonary a...
6970478 - Ventricular septal defect with aneurysm of the membranous septum and a parachute mitral...
18381878 - Hancock valve deterioration in tricuspid position for ebstein's anomaly.
10401228 - Extra-anatomical bypass with eptfe graft for residual pulmonary artery stenosis in tetr...
654858 - Acute effects of furosemide and mannitol on central haemodynamics in the early postoper...
3172798 - Operative predictors of delirium after pulmonary thromboendarterectomy. a model for pos...
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    
Affiliation:
Wessex Cardiothoracic Centre, Southampton General Hospital, Southampton, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Follow-Up Studies
Heart Catheterization
Heart Defects, Congenital / surgery*
Heart Septal Defects, Ventricular / surgery
Heart Ventricles / abnormalities
Hemodynamics / physiology
Humans
Infant
Infant, Newborn
Palliative Care
Postoperative Complications / diagnosis
Pulmonary Valve / abnormalities*,  surgery
Tricuspid Valve / abnormalities

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


Previous Document:  Immunohistologic separation of B-cell-positive granulomas from B-cell-negative granulomas in paraffi...
Next Document:  Reversible low-molecular-weight proteinuria in patients with distal renal tubular acidosis.