Document Detail


Surgical treatment of anomalies with discontinuity between the right ventricle and the pulmonary arteries without use of an extracardiac conduit.
MedLine Citation:
PMID:  19324156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Reoperation is usually inevitable for congenital cardiac patients after insertion of an extracardiac valved conduit. We sought to verify that a transannular patch on the autologous posterior wall with the common wall between the aorta and pulmonary artery can replace the conventional operation using an extracardiac conduit. METHODS: From August 1997 to October 2007, 31 patients (age 15 days to 19.3 years) underwent a procedure of autologous pulmonary floor with common wall between the great arteries and transannular patch to correct a right ventricle to pulmonary artery discontinuity at our hospital. The posterior pulmonary pathways were reconstructed by direct or indirect ventriculoarterial connection using tissue in situ or donated from the dominant aorta or truncus in all cases. The aorta or truncus was tailored transversely or longitudinally to donate the inner or outer wall to the pulmonary pathway as needed. RESULTS: There was no surgical mortality, and late noncardiac death occurred in 1 patient (3%). The postoperative systolic right ventricular to aortic pressure ratio was 0.48 +/- 0.11 in the operating theater, and the central venous pressure was 9 +/- 2 mm Hg. The follow-up duration was 5.5 +/- 3.3 years (range, 6 months to 10.6 years). In the follow-up echocardiography, significant pulmonary stenosis (pressure gradient > 40 mm Hg) was noted in 4 patients (13%). Follow-up computerized tomograms (n = 9) showed growth of the common wall. CONCLUSIONS: The tissue deficiency of the pulmonary outflow tract could be recruited from the outer wall or inner wall of the large aorta or truncus in this disease category. We recommend such an operation to correct a right ventricle to pulmonary artery discontinuity without using an extracardiac conduit.
Authors:
Ing-Sh Chiu; M Div; Shu-Chien Huang; Shye-Jao Wu; Meng-Luen Lee; En-Ting Wu; Shyh-Jye Chen; Ming-Ren Chen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  87     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-27     Completed Date:  2009-04-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1220-5; discussion 1225-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. ingsh@ntu.edu.tw
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cardiac Surgical Procedures / methods
Child
Child, Preschool
Female
Heart Defects, Congenital / surgery*
Heart Ventricles / surgery*
Humans
Infant
Infant, Newborn
Male
Pulmonary Artery / surgery*
Young Adult

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


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