Postoperative outcome in patients with anomalous origin of one pulmonary artery branch from the aorta

Prifti, Edvin; Crucean, Adrian; Bonacchi, Massimo; Bernabei, Massimo; Leacche, Marzia; Murzi, Bruno; Bartolozzi, Fabio; Vanini, Vittorio

doi:10.1016/s1010-7940(03)00187-8

Cited by 50 publications

(39 citation statements)

References 22 publications

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“…Five patients required a fixed autologous pericardial patch augmentation of pulmonary artery implant site. Contrary to other reports [1,18,21,23], there were no differences between direct implantation and autologous pericardial patch augmentation in lung perfusion and reintervention. We believe that aggressive mobilizing vessels can prevent tensioned anastomosis, even when using a pericardial patch for tension-free anastomosis.…”

Section: Discussioncontrasting

confidence: 98%

“…Early repair is preferred to avoid persistent pulmonary hypertension and irreversible pulmonary vascular occlusive disease. Hospital mortality has been reported from 0 to 21 % in previous reports [1,15,19,21] and a need for reintervention from 12.5 to 36 % [9]. Only one patient in our study suffered hospital mortality (8 %), and two patients required catheter-based intervention (17 %).…”

Section: Discussionmentioning

confidence: 42%

“…Direct implantation was introduced by Kirkpatrick et al [17] in 1967 and was most frequently used in the previous described series [1,15,18,19]. When direct implantation is not feasible, an aortic flap [23], interposition of an autologous pericardial patch, end-to-end anastomosis with a synthetic graft [9,21], or interposition of a homograft [1,18] have been successfully employed to increase the AOPA length in specific cases. In our study, direct implantation of the anomalous pulmonary artery in the main pulmonary artery was successful in seven of the 12 patients.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Results of Anomalous Origin of One Pulmonary Artery Branch from the Ascending Aorta

et al. 2015

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We reviewed our surgical experience with anomalous origin of one pulmonary artery from the ascending aorta (AOPA). From 1989 to 2012, 12 children (five neonates) aged 3-734 days (mean 152 ± 222) with AOPA underwent operations. Eight patients had right AOPA, and four patients had left AOPA. The majority of the patients had elevated right ventricular pressure, with 58 % (7 of 12) demonstrating suprasystemic right ventricular pressure. Surgery was performed by direct anastomosis (group 1) in seven patients and by employing an autologous patch (group 2) in five patients. There were two postoperative mortalities caused by heart failure and pulmonary hypertensive crisis. The mean follow-up duration was 12.6 ± 8 years. Catheterization showed that the right ventricle-to-systemic pressure ratio decreased following operation (preoperative vs. postoperative; 1.13 ± 0.19 vs. 0.48 ± 0.03, p = 0.043). There was no difference in the perfusion of the affected lung as measured by the final lung perfusion scan, between the two groups (group 1 vs. group 2; 50.0 ± 10.3 vs. 42.7 ± 28.7 %, p = 0.158). Two patients required reoperations for pulmonary regurgitation and pulmonary artery stenosis. There were two catheter-based interventions. At 20 years, survival by the Kaplan-Meier was 91.7 ± 8.0 %, freedom from reoperation was 80.0 ± 17.9 %, and freedom from catheter intervention was 80.8 ± 12.2 %. Early repair of AOPA improves right ventricular pressure and overall hemodynamics with excellent survival and low risk of reintervention. The type of surgical repair did not significantly affect the long-term outcomes (measured via lung perfusion scan).

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Section: Discussioncontrasting

confidence: 98%

Section: Discussionmentioning

confidence: 42%

Section: Discussionmentioning

confidence: 99%

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Surgical Results of Anomalous Origin of One Pulmonary Artery Branch from the Ascending Aorta

et al. 2015

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“…Unfortunately, in our case, the family declined surgery and the baby was discharged from hospital. Anomalies of the superior vena cava (SVC) include the presence of two veins as the right SVC (RSVC) and persistent left SVC (LSVC) 1 , the presence of an LSVC with an absent RSVC 2,3 and the very rare condition of the absence of both the right and left SVC 4 . In most cases with two SVCs the innominate vein connecting the jugular vein with the opposite SVC is absent 1,5 .…”

mentioning

confidence: 99%

Prenatal diagnosis of anomalous origin of the right pulmonary artery from the ascending aorta with hypoplastic right ventricle and pulmonary stenosis

Öztunç¹,

Güzeltaş²

2008

Ultrasound in Obstet & Gyne

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Prenatal diagnosis of anomalous origin of the right pulmonary artery from the ascending aorta with hypoplastic right ventricle and pulmonary stenosis A 24-year-old woman was referred at 35 weeks' gestation for prenatal echocardiography due to a suspected cardiac anomaly on routine ultrasound examination. There was no history of medication use during pregnancy. Ultrasound examination showed normal fetal growth and no other organ anomalies or hydrops fetalis. Fetal echocardiography detected a hypoplastic right ventricle (diameter, 10 mm, vs. left ventricle, 25 mm) and tricuspid hypoplasia (annulus diameter, 5 mm) with valvar pulmonary stenosis (velocitiy, 2.5 m/s) (Figure 1). The main pulmonary artery was continuous with the left pulmonary artery and there was no confluence with the right pulmonary artery. The ventricular septum was intact. On detailed examination it was noted that the right pulmonary artery arose from the ascending aorta with a normal left pulmonary branch from the main pulmonary artery (Figure 2). The pregnancy was uneventful, and spontaneous vaginal delivery occurred at 38 weeks' gestation.Echocardiographic examination on the first postnatal day confirmed the above findings. Additionally, a small secundum atrial septal defect was detected. The tricuspid annulus Z-value score was −4, right ventricular volume was 1.5 cm 3 , left ventricular volume was 8.7 cm 3 and the pulmonary valve was thick and stenotic with a gradient of 85 mmHg. The right pulmonary artery diameter was

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“…AOPA may be caused by the absence of the left sixth arch, resulting in the failure of connection of the AOPA to the pulmonary trunk and the persistence of the aortic sac from which the AOPA originates 2 . This anomaly is usually associated with the other cardiac malformations 3 . Tetralogy of Fallot associated with APW and AOPA is rare, which can cause secondary pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

One-Stage Correction of Tetralogy of Fallot Associated with Anomalous Origin of the Left Pulmonary Artery from the Aorta and Aortopulmonary Window

Sun

Qin

Liang

2011

Journal of Cardiac Surgery

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We report a rare case of tetralogy of Fallot associated with anomalous origin of the left pulmonary artery from the aorta and aortopulmonary window. Successful one-stage total correction was performed under cardiopulmonary bypass, including implantation of the left pulmonary artery, repair of aortopulmonary window, and correction of tetralogy of Fallot. The patient experienced an uneventful postoperative course and was asymptomatic at one-year follow-up.

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Postoperative outcome in patients with anomalous origin of one pulmonary artery branch from the aorta

Cited by 50 publications

References 22 publications

Surgical Results of Anomalous Origin of One Pulmonary Artery Branch from the Ascending Aorta

Surgical Results of Anomalous Origin of One Pulmonary Artery Branch from the Ascending Aorta

Prenatal diagnosis of anomalous origin of the right pulmonary artery from the ascending aorta with hypoplastic right ventricle and pulmonary stenosis

One-Stage Correction of Tetralogy of Fallot Associated with Anomalous Origin of the Left Pulmonary Artery from the Aorta and Aortopulmonary Window

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