Document Detail


Pulmonary atresia with ventricular septal defects and major aortopulmonary collateral arteries.
MedLine Citation:
PMID:  19179776     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is no consensus on the long-term outcome after unifocalization in patients undergoing surgery for pulmonary atresia with ventricular septal defects (VSD) and major aortopulmonary collateral arteries (MAPCAs). METHODS AND RESULTS: From 1988 to 2006, 40 patients (median age 8.5 months) underwent surgery for pulmonary atresia, VSD, and MAPCAs. The hospital mortality rate for the preparatory procedures was 1.2%; 17 patients had a complete repair (CR) at a median age of 3 years. Patients with a pulmonary artery index greater than 100 mm(2)/m(2) had a higher likelihood of CR. The overall survival rate 15 years after first operation in the CR group was 87.5%. Cox analysis demonstrated that increased number of MAPCAs (P=0.019, HR=1.666) was a significant predictor of poor survival, and CR (P=0.025, HR=0.141) was a significant predictor of favorable prognosis. On angiography, serial measurements of MAPCAs showed a significant decrease in size (from 5.2+/-2.9 to 4.1+/-2.9 mm after a mean of 20 months) (P<0.0001). CONCLUSIONS: Long-term survival into adulthood can be achieved with an integrated approach. Late survival depends on the number of MAPCAs, and CR. Growth potential of unifocalized MAPCAs was not definite.
Authors:
Suk-Won Song; Han Ki Park; Young-Hwan Park; Bum Koo Cho
Publication Detail:
Type:  Journal Article     Date:  2009-01-28
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  73     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-02-27     Completed Date:  2009-06-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  516-22     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aorta, Thoracic / abnormalities*,  radiography,  surgery
Child
Child, Preschool
Collateral Circulation
Coronary Angiography
Coronary Circulation
Female
Follow-Up Studies
Heart Septal Defects, Ventricular / mortality*,  radiography,  surgery*
Humans
Infant
Infant, Newborn
Kaplan-Meiers Estimate
Male
Pulmonary Artery / abnormalities*,  radiography,  surgery
Pulmonary Atresia / mortality*,  radiography,  surgery*
Reoperation / statistics & numerical data
Risk Factors

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


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