Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-06-09T08:35:36.239Z Has data issue: false hasContentIssue false
  • English
  • Français

Use of pulmonary arterial unifocalization into cryopreserved homograft pulmonary arterial bifurcation grafts to facilitate complete correction of pulmonary atresia with ventricular septal defect, nonconfluent (absent) central pulmonary arteries and multiple major aortopulmonary collateral arteries

Published online by Cambridge University Press:  19 August 2008

Richard A. Hopkins ,
Deborah A. Imperato ,
John T. Cockerham  and
Stephen R. Shapiro
Richard A. Hopkins*
Affiliation:
From Pediatric Cardiac Surgery and Cardiology, Georgetown Medical Center, Washington, DC
Deborah A. Imperato
Affiliation:
From Pediatric Cardiac Surgery and Cardiology, Georgetown Medical Center, Washington, DC
John T. Cockerham
Affiliation:
From Pediatric Cardiac Surgery and Cardiology, Georgetown Medical Center, Washington, DC
Stephen R. Shapiro
Affiliation:
From Pediatric Cardiac Surgery and Cardiology, Georgetown Medical Center, Washington, DC
*
Dr. Richard A. Hopkins, Georgetown University, Department of Surgery, 3800 Reservoir Road, NW, Washington, DC 20007, USA. Tel. 202-687-1265; Fax. 202-687-6498.
Get access Rights & Permissions [Opens in a new window]

Abstract

Three children with pulmonary atresia and ventricular septal defect with absent central pulmonary arteries underwent successful complete correction following preliminary staging procedures for unifocalization and deletion of multiple major aortopulmonary collateral arteries. The unifocalization procedures were accomplished using valveless pulmonary arterial cryopreserved allografts. This technique was found to facilitate and simplify the final repair. All patients survived the complete correction. The patients have been followed for 1½-4 years following the final surgery. One child died two years after repair from pneumonia complicated by asthma. One patient appears to have progression of pulmonary vascular disease despite the complete repair, and one patient continues to do well both symptomatically and hemodynamically. The results suggest that this method of unifocalization solves many of the problems inherent to more classical techniques, but the overall prognosis of patients in this diagnostic entity has yet to be completely defined.

Keywords

Homografttetralogy of Fallot with pulmonary atresiaunifocalization
Type
Original Manuscripts
Information
Cardiology in the Young , Volume 5 , Issue 3 , July 1995 , pp. 217 - 224
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Puga, FJ. Unifocalization for pulmonary atresia with ventricular septal defect. Ann Thorac Surg 1991; 51: 8–9.CrossRefGoogle ScholarPubMed
2.Sullivan, ID, Wren, C, Stark, J, De Leval, MR, Macartney, FJ, Deanfield, JE. Surgical Unifocalization in pulmonary atresia and ventricular septal defect. A realistic goal? Circulation 1988; 78(Supp. III): III5–III13.Google ScholarPubMed
3.Puga, FJ, McGoon, DC, Julsrud, PR, Danielson, GK, Mair, DD. Complete repair of pulmonary atresia with nonconfluent pulmonary arteries. Ann Thorac Surg 1983; 35: 36–44.CrossRefGoogle ScholarPubMed
4.Sawatari, K, Imai, Y, Kurosawa, H, Isomatsu, Y, Momma, K. Staged operation for pulmonary atresia and ventricular septal defect with major aortopulmonary collateral series. New technique for complete Unifocalization. J Thorac Cardiovasc Surg 1989; 98: 738–750.CrossRefGoogle Scholar
5.Barbero-Marcial, M, Rizzo, A, Lopes, AAB, Bittencourt, D, Junior, JOA, Jatene, AD. Correction of pulmonary atresia with ventricular septal defect in the absence of the pulmonary trunk and the central pulmonary arteries (so-called truncus type IV). J Thorac Cardiovasc Surg 1987; 94: 911–918.CrossRefGoogle ScholarPubMed
6.Iyer, KS, Mee, RBB. Staged repair of pulmonary atresia with ventricular septal defect and major systemic to pulmonary artery collaterals. Ann Thorac Surg 1991; 51: 65–72.CrossRefGoogle ScholarPubMed
7.Puga, FJ, Leoni, FE, Julsrud, PR, Mair, DD. Complete repair of pulmonary atresia, ventricular septal defect, and severe peripheral arborization abnormalities of the central pulmonary arteries. J Thorac Cardiovasc Surg 1989; 98: 1018–1029.CrossRefGoogle ScholarPubMed
8.Iyer, KS, Varma, M, Mee, RBB. Use of azygos vein as interposition graft for surgical unifocalization of pulmonary blood supply. Ann Thorac Surg 1989; 48: 776–778.CrossRefGoogle ScholarPubMed
9.Shanley, CJ, Lupinetti, FM, Shah, NL, Beekman, RH III, Crowley, DC, Bove, EL. Primary unifocalization for the absence of intrapericardial pulmonary arteries in the neonate. J Thorac Cardiovasc Surg 1993; 106: 237–247.CrossRefGoogle ScholarPubMed