Juxtaductal left pulmonary artery obstruction in pulmonary atresia.

Abstract

with pulmonary atresia associated with various other congenital anomalies in whom the central pulmonary artery originally gave rise to right and left pulmonary arteries. Twenty one patients who had not been treated surgically form the present study group. They range in age from 11 days to 21 years (median 4 years). Eight are males and 13 are females (Table). All were investigated by cross sectional echocardiography and angiocardiography. The morphology of the central pulmonary artery (pulmonary trunk and main branches) was studied by biplane cut-film or cine angiography. After ventriculography or aortography, selective pulmonary angiography was performed by catheterisation of the persistent ductus arteriosus, except in one patient (case 6) in whom the ductus arteriosus was not patent and in five patients under the age of 1 year (cases 1, 2, 7, 8, and 16). In case 6 the entire central pulmonary artery was visualised by pulmonary vein wedge angiography. In the five infants the central pulmonary artery was clearly visualised by aortography. In six patients (cases 16-21) the proximal left pulmonary artery was atretic and angiography through the ductus arteriosus showed only the distal left pulmonary artery. In three (cases 17, 18, and 20) of these six patients a right pulmonary arteriogram was obtained by injection of contrast medium into the right pulmonary vein wedge position.

Catheterization Treatment of Stenosis and Hypoplasia of Pulmonary Arteries

“…Most congenital stenoses are the result of congenital heart disease with pulmonary undercirculation, such as tetralogy of Fallot, tetralogy of Fallot with pulmonary trunk atresia, and tricuspid valve atresia with pulmonary stenosis or atresia. Another type of congenital narrowing, especially in the left pulmonary artery, is due to coarctation formed at the site of insertion of the patent ductus arteriosus or ligamentum arteriosum, when some of the constricting tissue involves or encircles the pulmonary artery [11,12,30,34]. Branch pulmonary artery stenosis is a well-known feature of Williams syndrome [16,18], Alagille syndrome, and congenital rubella [10,57].…”

Neonatal Pulmonary Artery Reconstruction During Shunting to Treat and Prevent Juxtaductal Coarctation

“…half ventricle repair (1); bidirectional cavopulmonary shunt (4); and Fontan (2). Fourteen of the patients destined for biventricular physiology reached complete repair while 2 patients were still with shunts.…”

Coarctation of the Left Pulmonary Artery: Effects on the Pulmonary Vasculature of Infants

“…Pulmonary arterial stenoses are often associated with other cardiovascular anomalies [19]. Momma et al [23], in an angiographic study, found nine cases of juxtaductal LPA stenosis and five cases of juxtaductal LPA atresia. Baum et al [1], in a clinicoradiologic study, reported 26 cases of pulmonary arterial branch stenoses.…”