Document Detail


Staged biventricular repair of pulmonary atresia or stenosis with intact ventricular septum.
MedLine Citation:
PMID:  11093477     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Since 1991 we have performed a multistage palliative approach to biventricular repair of pulmonary atresia or critical pulmonary stenosis with intact ventricular septum in infants with a detectable right ventricular infundibulum. METHODS: A total of 25 patients (19 pulmonary atresia and 6 critical pulmonary stenosis) underwent initial palliation consisting of a transarterial pulmonary valvotomy and a polytetrafluoroethylene shunt between the left subclavian artery and pulmonary trunk. Among the 23 survivors, 15 underwent balloon valvotomy. Six of these patients later required additional palliative surgery that consisted of repeat pulmonary valvotomy, adjustment of an atrial communication, and resection of the hypertrophied muscles in the right ventricle. RESULTS: Of the 25 patients, 23 (92%) survived. In all, 20 patients underwent definitive operations: 18 (90%) biventricular repair (12 pulmonary atresia, and 6 critical pulmonary stenosis), one bidirectional Glenn, and one Fontan procedure. The actuarial probability of achieving a biventricular repair at 36 months of age was 69%. In 18 patients right ventricular end-diastolic volume significantly increased but tricuspid valve diameter did not change. CONCLUSIONS: The multistage palliation procedure to promote right ventricular growth makes a definitive biventricular repair of pulmonary atresia or critical pulmonary stenosis with intact ventricular septum possible in the majority of infants with a patent infundibulum.
Authors:
S Sano; K Ishino; M Kawada; E Fujisawa; M Kamada; S Ohtsuki
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  70     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-01-05     Completed Date:  2001-01-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1501-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, Okayama University Medical School, Okayama-City, Japan. s-sano@cc.okayama-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Balloon Dilatation
Cardiac Surgical Procedures / methods
Female
Fontan Procedure
Heart Septum
Heart Ventricles
Humans
Infant
Infant, Newborn
Male
Palliative Care / methods
Pulmonary Atresia / surgery*
Pulmonary Valve Stenosis / surgery*

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


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