| Spontaneous acquisition of discontinuous pulmonary arteries. | |
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MedLine Citation:
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PMID: 8678637 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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J D Waldman; R B Karp; A C Gittenberger-de Groot; B Agarwala; S Glagov |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 62 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1996 Jul |
Date Detail:
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Created Date: 1996-08-14 Completed Date: 1996-08-14 Revised Date: 2010-03-24 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 161-8 Citation Subset: AIM; IM |
Affiliation:
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University of Chicago, Illinois, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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745-65-3/Alprostadil |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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