Atresia Pulmonar com Comunicação Interventricular

Abstract

Estudos cineangiocardiográficos, mostrando as variações anatômicas do suprimento sangüíneo vascular pulmonar, conforme classificação de Barbero-Marcial para atresia pulmonar com comunicação interventricular.

The pulmonary vascular blood supply in the pulmonary atresia with ventricular septal defect and its implications in surgical treatment

“…Within group A, in the A1 subgroup the mean PAI was 222.11. This data is compatible with data found by Nakata et al [8] who studied a group of patients with Fallot's tetrad and found a PAI of between 150 and 250 mm 2 /m 2 in the majority of the cases and favorable results with indices greater than 200 mm 2 /m 2 . All the patients in this subgroup achieved DT, independently of the PAI, demonstrating that there was no correlation between this characteristic and the treatment.…”

“…After this calibration, the diameters of the CPA and MAPCA were measured. The CPA were measured immediately proximal to the root of the first lobar branch [8] and the MAPCA was measured distally to the point in which ideally the surgical unifocalization would be possible [9].…”

“…In 1984, Nakata et al [8] proposed a method for the calculation of the area of CPA, which allows calculation of the pulmonary arterial index (PAI) and which can be applied to patients with blood supplies from a distinct origin (Group A).…”

Avaliação do suprimento sangüíneo vascular pulmonar nos portadores de atresia pulmonar com comunicação interventricular e artérias colaterais sistêmico-pulmonares

“…Comparing that classification with the one adopted in our study, type C (atresia of the pulmonary valve and trunk and one of the pulmonary arteries) in the Somerville classification corresponds to our group B, in which the pulmonary segments are irrigated by the PPAA and APCA 5 . Investigation of the hemodynamic aspects of the pulmonary circulation, using selective catheterization and occlusion with a balloon for visualizing APCA, showed that some pulmonary segments are supplied by blood flow originating from the PPAA, while others are supplied by the APCA 11 .…”

“…Due to this extreme heterogeneity, several anatomical classifications have been proposed, aiming at establishing criteria that rationalize the surgical approach. The currently most-used morphological classification [2][3][4][5] divides the patients with PA and VSD into 3 different groups: A, B, and C. In group A, all pulmonary segments are supplied by PPAA. In group B, some pulmonary segments are supplied by PPAA, while others are supplied by APCA.…”