Surgical Repair of Pulmonary Atresia With Ventricular Septal Defect and Major Aortopulmonary Collaterals With Absent Intrapericardial Pulmonary Arteries

Conclusions The majority of patients with PA/VSD/MAPCAs and absent pulmonary arteries can undergo complete single-stage repair with satisfactory postoperative hemodynamics. These results suggest that unifocalization of MAPCAs can provide a reasonable pulmonary vascular bed in the absence of intrapericardial pulmonary arteries.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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In this study, we report the combined outcomes from 2 hospitals using different strategies. METHODS: Between 2004 and 2017, 66 neonates underwent surgery with palliative shunts (BTS group: n=30, 45.5%) or primary biventricular repair (pBVR group: n=36, 54.5%). The two groups were similar in age, body weight, and Nakata index scores. The overall mean follow-up duration was 7.51 ± 4.35 years, and early and late results were compared between the groups. RESULTS: The 10-year overall survival was 84.8% (94.4% for pBVR versus 75.7% for BTS, p=0.032). The BTS group had 2 early and 6 interstage mortalities, while ...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
AbstractObjectiveThe systemic ‐to‐pulmonary shunt (SPS) and right ventricle to pulmonary artery (RV‐PA) connection were evaluated to pursue the goal of rehabilitating dysplastic native PAs via establishment of antegrade blood flow. However, the application of these two palliative operations was still confusing. We compared the two operations to determine their different effects on patients who have pulmonary atresia, ventricular septal defects, and major aortopulmonary collateral arteries (MAPCAs).MethodsFrom January 2011 to January 2016, 44 patients received the SPS procedure, and 54 patients received the RV ‐PA c...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
In the current issue of the Seminars, Patel and colleagues from India report outcomes in 25 patients with ventricular septal defect and pulmonary atresia (VSD/PA) who underwent valveless right ventricle to pulmonary artery (RV-PA) shunt as initial palliative surgery.1 There was one operative and one late death. Among the remaining 23 patients, 17 achieved full repair while 6 were awaiting full repair. The distinctive aspect of this series is that the mean age of patients was 12.3 ±3.2 years, much older than VSD/PA patients in the North America or Europe who typically receive surgery during infancy.
Source: Seminars in Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CONGENITAL – Editorial Commentary Source Type: research
CONCLUSION: For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient's condition. PMID: 30032587 [PubMed]
Source: Korean Journal of Pediatrics - Category: Pediatrics Tags: Korean J Pediatr Source Type: research
AbstractThe management of pulmonary atresia with a ventricular septal defect (PA/VSD) depends on the anatomy of the pulmonary artery or on the surgical strategy used at individual institutions. In our institution, we adopted a right ventricle-to-pulmonary artery (RV-PA) shunt in 2011 as a palliative procedure for PA/VSD to overcome the disadvantages of a Blalock-Taussig shunt. We evaluated the results of the RV-PA shunt as initial palliative surgery for PA/VSD. Thirteen patients with ductus-dependent PA/VSD from August 2011 to August 2015 were enrolled. The mean age at surgery was 17.9  ± 15.3 (range 5...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
CONCLUSIONS: The safety and feasibility of Biotubes for pediatric PA patch augmentation are described. Because Biotubes are completely autologous, they may be ideal material for pediatric PA augmentation. PMID: 27645948 [PubMed - in process]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
OBJECTIVES The systemic-to-pulmonary shunt (SPS) remains an important palliative therapy in many congenital heart defects. Unlike other surgical treatments, the mortality after shunt operations has risen. We used an audit dataset to investigate potential reasons for this change and to report national results. METHODS A total of 1993 patients classified in 13 diagnoses underwent an SPS procedure between 2000 and 2013. Indication trends by era and also results before repair or next stage are reported. A dynamic hazard model with competing risks and modulated renewal was used to determine predictors of outcomes. RESULTS The...
Source: European Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Mechanical Circulatory Assistance, History CONGENITAL Source Type: research
This study evaluated 41-year experience of outcome, survival and treatment of PA + VSD patients. METHODS Patient records and angiograms of 109 patients with PA + VSD born in Finland between 1970 and 2007, and treated at the Children's Hospital, Helsinki University Central Hospital, were retrospectively analysed in this nationwide study. RESULTS Of the 109 patients, 66 (61%) had simple PA + VSD without major aortopulmonary collateral arteries (MAPCAs). Although we observed no difference in overall survival between those with or without MAPCAs, the patients without MAPCAs had better probability to achieve repair (64 vs 28%, P
Source: European Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Mechanical Circulatory Assistance CONGENITAL Source Type: research
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 7. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rate...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
is a cyanotic congenital heart disease in which one single great vessel with a single semilunar valve gives rise to the aorta, pulmonary arteries and the coronary arteries. There are three morphological types depending on the origin of pulmonary arteries from the truncus. In type I, a common pulmonary trunk arises from the truncus arteriosus and divides into left and right pulmonary arteries. In type II, the two pulmonary arteries arises separately, but adjacent to each other, from the truncus. In type III, the two pulmonary arteries arise separately from either side of the truncus. The older classification had a type IV ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: ECG / Electrophysiology General Cardiology Source Type: blogs
More News: Anatomy | Atresia | Cardiovascular & Thoracic Surgery | Gastroschisis Repair | Hole in the Heart | Palliative | Palliative Care | Study | Ventricular Septal Defect