Autologous pulmonary arterial flap for repair of truncus arteriosus in neonate and small infants

S. Nakae, A. Kawada, A. Kurata, Shingo Kasahara, Y. Suzuki, M. Hayashi, A. Ishihara, K. Yoshimura

Research output: Contribution to journalArticle

Abstract

Complete correction without external conduit repair by autologous pulmonary arterial flap was performed for the truncus arteriosus in one neonate and two small infants. In this study, we investigated advantages of postoperative hemodynamics and pulmonary artery growth from the data on truncus arteriosus repaired by the autologous flap technique. Patient in this study was classified as type I or II truncus arteriosus and age ranged from 19 days to 95 days after birth. One of the patients died of unexpected gastric bleeding 25 days after surgery. However, all showed excellent hemodynamics in the early postoperative period. The reconstructed pulmonary tract positioned rather left ward and posterior to the level of the systemic root than the technique with extra cardiac conduit repair. Compression did not occur at the created pulmonary tract and hemodynamics was fairly stable after closure of the chest. The postoperative RVP/LVP ratio ranged among 0.45 to 0.65 and the pressure gradient across the right ventricular out flow tract demonstrated only 10-15 mmHg. The size of the pulmonary arterial flap was sufficient even in type II truncus arteriosus to create right ventricle-to-pulmonary tract. However, the first patient underwent subsequent surgery 20 months after the initial surgery, because of left pulmonary artery stenosis due to intimal tissue overgrowth distal to the outflow patch. Surgical findings revealed that the posterior wall of the pulmonary tract was smooth and well developed. Traction of pulmonary arterial flap toward the right ventricular outflow tract shortens the distance between monocusp and left pulmonary arterial orifice than expected.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish
Pages (from-to)1336-1342
Number of pages7
JournalJournal of the Japanese Association for Thoracic Surgery
Volume42
Issue number9
Publication statusPublished - Sep 1994
Externally publishedYes

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Truncus Arteriosus
Newborn Infant
Lung
Hemodynamics
Tunica Intima
Traction
Ambulatory Surgical Procedures
Postoperative Period
Pulmonary Artery
Heart Ventricles
Stomach
Thorax
Parturition
Hemorrhage
Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Autologous pulmonary arterial flap for repair of truncus arteriosus in neonate and small infants. / Nakae, S.; Kawada, A.; Kurata, A.; Kasahara, Shingo; Suzuki, Y.; Hayashi, M.; Ishihara, A.; Yoshimura, K.

In: Journal of the Japanese Association for Thoracic Surgery, Vol. 42, No. 9, 09.1994, p. 1336-1342.

Research output: Contribution to journalArticle

Nakae, S, Kawada, A, Kurata, A, Kasahara, S, Suzuki, Y, Hayashi, M, Ishihara, A & Yoshimura, K 1994, 'Autologous pulmonary arterial flap for repair of truncus arteriosus in neonate and small infants', Journal of the Japanese Association for Thoracic Surgery, vol. 42, no. 9, pp. 1336-1342.
Nakae, S. ; Kawada, A. ; Kurata, A. ; Kasahara, Shingo ; Suzuki, Y. ; Hayashi, M. ; Ishihara, A. ; Yoshimura, K. / Autologous pulmonary arterial flap for repair of truncus arteriosus in neonate and small infants. In: Journal of the Japanese Association for Thoracic Surgery. 1994 ; Vol. 42, No. 9. pp. 1336-1342.
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