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 language | English |
|---|---|
| Pages (from-to) | 1336-1342 |
| Number of pages | 7 |
| Journal | Journal of the Japanese Association for Thoracic Surgery |
| Volume | 42 |
| Issue number | 9 |
| Publication status | Published - Sep 1994 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
T1 - Autologous pulmonary arterial flap for repair of truncus arteriosus in neonate and small infants
AU - Nakae, S.
AU - Kawada, A.
AU - Kurata, A.
AU - Kasahara, Shingo
AU - Suzuki, Y.
AU - Hayashi, M.
AU - Ishihara, A.
AU - Yoshimura, K.
PY - 1994/9
Y1 - 1994/9
N2 - 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)
AB - 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)
UR - http://www.scopus.com/inward/record.url?scp=0342899891&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0342899891&partnerID=8YFLogxK
M3 - Article
C2 - 7989793
AN - SCOPUS:0342899891
VL - 42
SP - 1336
EP - 1342
JO - General Thoracic and Cardiovascular Surgery
JF - General Thoracic and Cardiovascular Surgery
SN - 1863-6705
IS - 9
ER -