Document Detail


Spontaneous acquisition of discontinuous pulmonary arteries.
MedLine Citation:
PMID:  8678637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Discontinuous pulmonary arteries have been considered a rare complication of systemic-to-pulmonary shunt operations. We report a series of children who spontaneously acquired pulmonary artery discontinuity. METHODS: All children from 1989 through 1995 with congenital pulmonary atresia were reviewed. RESULTS: Pulmonary artery discontinuity developed in 29% (15 patients), none related to shunt operation. In 6 of 15 patients, the neonatal angiogram showed a pattern that seemed to predict subsequent discontinuity; in 9 of 15, pulmonary arteriography was normal at birth. Two clinical patterns were identified: an early rapid acquisition of discontinuity within hours to days, and a delayed, more subtle development that occurred over months. Eight of 15 have died. Pathologic studies in 6 children showed ductal tissue extending along and into the pulmonary artery wall as well as intimal hypertrophic reaction and maladaptive remodeling. CONCLUSIONS: Children with congenital pulmonary atresia may experience spontaneous acquisition of pulmonary artery discontinuity. Ductal tissue is responsible for local pulmonary artery distortion and discontinuity; this may be exacerbated by previous prostaglandin E1 administration. Clinical algorithms are suggested for patients with pulmonary atresia.
Authors:
J D Waldman; R B Karp; A C Gittenberger-de Groot; B Agarwala; S Glagov
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  62     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1996 Jul 
Date Detail:
Created Date:  1996-08-14     Completed Date:  1996-08-14     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  161-8     Citation Subset:  AIM; IM    
Affiliation:
University of Chicago, Illinois, USA.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Alprostadil / adverse effects,  therapeutic use
Ductus Arteriosus / pathology
Heart Catheterization
Heart Defects, Congenital / complications,  pathology,  surgery
Humans
Infant
Infant, Newborn
Pulmonary Artery / pathology*,  radiography
Pulmonary Atresia / complications*,  pathology,  surgery
Tunica Intima / pathology
Chemical
Reg. No./Substance:
745-65-3/Alprostadil

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


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