• Y Suzuki, Y Ikeda, M Hisagi, and S Nakayama.
• Department of Cardiovascular Surgery, Tokyo Metropolitan Hachioji Children's Hospital, Tokyo, Japan.
• Kyobu Geka. 2004 Feb 1; 57 (2): 100-6.

AbstractThe management of small pulmonary artery in tetralogy of Fallot (TOF) with pulmonary atresia (PA) is complicated. Our strategy is palliative right ventricle outflow tract reconstruction (RVOTR). The aim of this study is to determine whether palliative RVOTR is useful as the first stage operation. Since 1994, 7 patients with TOF, pulmonary atresia and hypoplastic pulmonary arteries underwent palliative RVOTR. All patients survived operation without complication except for 1. He had pseudoaneurysm at right ventricular outflow patch requiring aneurysmectomy and re-RVOTR 1.5 months after the initial RVOTR. Nine months after RVOTR in the average, pulmonary artery index (PAI) increased from 139 +/- 87 to 306 +/- 156 (p < 0.05). No patient had pulmonary high flow or pulmonary hypertension. Two of them had pulmonary coractation due to ductal tissue in the pulmonary artery, necessitating additional modified Blalock-Taussig shunts at 8 and 10 months old. One patient with TOF, PA, major aorto-pulmonary collateral artery (MAPCA) had corrective surgery after 2 additional operations and interventional catheterization. Five patients of this series already have undergone corrective surgery, whereas 1 is waiting for it. RVOTR is a useful method for pulmonary artery growth in patients with TOF, PA and diminutive pulmonary artery.

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