Pulmonary Atresia with Ventricular Septal Defect and Multifocal Pulmonary Blood Supply: Does an Intensive Interventional Approach Improve the Outcome?

Learn, Christopher P.; Phillips, Alistair; Chisolm, Joanne L.; Hill, Sharon L.; Cheatham, John P.; Winch, Peter D.; Galantowicz, Mark; Holzer, Ralf

doi:10.1111/j.1747-0803.2011.00590.x

Cited by 6 publications

(2 citation statements)

References 19 publications

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“…Two patients in this study had residual VSDs due to fenestrated patch closures. In these circumstances, VSD closure is performed using a fenestrated or valved patch to reduce the risk of right heart decompensation [12, 13]. After postoperative stabilization and further interventional management of hypoplastic or stenotic pulmonary arteries, VSD closure may be necessary at a later date.…”

Section: Discussionmentioning

confidence: 99%

The experience of transcatheter closure of postoperative ventricular septal defect after total correction

Kouakou

Song

Huh

et al. 2019

J Cardiothorac Surg

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Background The purpose of this study was to describe our experience with patients who underwent transcatheter closure of a post-operative ventricular septal defect (VSD). Methods All patients who underwent transcatheter closure of a VSD after total correction of congenital heart disease since 2012 were enrolled. Medical records were retrospectively reviewed to determine the patients’ initial diagnosis, closure device used, and final outcome after device closure. Results Six patients with a median age of 17.7 years (range: 7 months–48 years) underwent transcatheter closure of an unresolved VSD. The median time interval from the initial corrective surgery to the percutaneous closure procedure was 10.4 years (range: 0.3–33.0 years). The initial diagnoses included tetralogy of Fallot (one patient), VSD (two patients), double outlet of the right ventricle (two patients), and aortic valve stenosis (one patient). The reasons for unresolved VSD (other than leakage) after corrective surgery included previous fenestration (in two patients), and iatrogenic Gerbode shunt (in one patient). Various devices were used, including the Amplatzer duct occluder I, Amplatzer duct occluder II, Amplatzer vascular plug II, and Cocoon membranous VSD occluder. Only one device was used in each patient. There were no major complications associated with the closure procedures. The immediate results were satisfactory. The median follow-up duration was 2.75 years. All cases were successful, with the exception of minimal leak in one patient. Conclusions Transcatheter device closure of post-operative VSD can be performed using various device types of devices and is safe and effective. But more experiences are mandatory.

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Section: Discussionmentioning

confidence: 99%

The experience of transcatheter closure of postoperative ventricular septal defect after total correction

Kouakou

Song

Huh

et al. 2019

J Cardiothorac Surg

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“…Learn et al reported that multiple interventions are essential for this entity. 11 Catheter interventions were carried out 11 times for our five patients with focal pulmonary stenosis before the palliative intra-cardiac repair, and over 20 times after the palliative intra-cardiac repair. Surgical interventions for focal pulmonary stenosis were also carried out in two patients after the palliative intra-cardiac repair.…”

Section: Discussionmentioning

confidence: 99%

Long-term results after palliative intra-cardiac repair for tetralogy of Fallot and diminutive pulmonary arteries

et al. 2019

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Background:In patients with tetralogy of Fallot with the diminutive pulmonary arteries, we sometimes have to give up the complete intra-cardiac repair due to insufficient growth of the pulmonary arteries. We have carried out palliative intra-cardiac repair using a fenestrated patch.Methods:Of all 202 patients with tetralogy of Fallot in our centre since 1996, five patients (2.5%) with the diminutive pulmonary arteries underwent palliative intra-cardiac repair using a fenestrated patch. Mean operative age was 1.8 years. Previous operation was Blalock–Taussig shunt in 4. At operation, the ventricular septal defect was closed using a fenestrated patch and the right ventricular outflow tract was enlarged. Follow-up period was 9.8 ± 2.6 years.Results:There were no operative and late deaths. Fenestration closed spontaneously on its own in four patients 2.7 ± 2.1 years after the intra-cardiac repair with a stable haemodynamics; however, the last patient with the smallest pulmonary artery index had supra-systemic pressure of the right ventricle post-operatively. The fenestration was emergently enlarged. Systemic arterial oxygen saturation was significantly and dramatically increased from 83.5 to 94% after the palliative intra-cardiac repair, and to 98% at the long term. A ratio of systolic pressure of the right ventricle to the left was significantly decreased to 0.76 ± 0.12 at the long term. Now all five patients were Ross classification class I.Conclusion:Although frequent catheter and surgical interventions were needed after the palliative intra-cardiac repair, this repair might be a choice improving quality of life with good results in patients with tetralogy of Fallot associated with the diminutive pulmonary arteries.

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Tetralogy of Fallot with Pulmonary Atresia

Domnina¹,

Koh²,

López-Magallón³

et al. 2020

Critical Care of Children With Heart Disease

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Pulmonary Atresia with Ventricular Septal Defect and Multifocal Pulmonary Blood Supply: Does an Intensive Interventional Approach Improve the Outcome?

Cited by 6 publications

References 19 publications

The experience of transcatheter closure of postoperative ventricular septal defect after total correction

The experience of transcatheter closure of postoperative ventricular septal defect after total correction

Long-term results after palliative intra-cardiac repair for tetralogy of Fallot and diminutive pulmonary arteries

Tetralogy of Fallot with Pulmonary Atresia

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