The assessment of the arterial supply to the lungs in pseudotruncus arteriosus and truncus arteriosus Type IV in relation to surgical repair

Chesler, Elliot; Matisonn, Rodney E.; Beck, Walter

doi:10.1016/0002-8703(74)90236-1

Cited by 20 publications

(10 citation statements)

References 15 publications

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“…In truncus arteriosus with absent pulmonary arteries ('type IV'), they have not developed, since no remnants of pulmonary arteries are observed (Thiene et al, 1976). In contrast, in (Jefferson et al, 1972;Macartney et al, 1973;Chesler et al, 1974). None the less, we believe that the distinction should be maintained, since the two malformations are developmentally and morphologically distinct.…”

Section: Pulmonary Circulation In Pulmonary Atresia With Ventricular mentioning

confidence: 86%

“…Various terms have been suggested to describe these anastomotic vessels: bronchial arteries (Chesler et al, 1974), aortico-pulmonary collateral arteries (Kouchoukos et al, 1971;Macartney et al, 1974), and systemic arteries (Jefferson et al, 1972). The term 'bronchial arteries' is inaccurate from both an anatomical and embryogenetic point of view.…”

Section: Pulmonary Circulation In Pulmonary Atresia With Ventricular mentioning

confidence: 99%

“…While cases of pulmonary atresia without a pulmonary infundibulum have been reported (Allanby et al, 1950;Chesler et al, 1974), no specimen of complete agenesis of the main pulmonary trunk and pulmonary arteries which exhibits a blind or potential pulmonary infundibulum has thus far been described. It could be argued that truncus arteriosus 'type IV' should not be regarded as truncus arteriosus 'communis' since the absent pulmonary arteries are not contributing to the single arterial trunk.…”

Section: Pulmonary Circulation In Pulmonary Atresia With Ventricular mentioning

confidence: 99%

“…Since many examples of the anomaly have now undergone correction, it has been the subject of numerous clinical (Miller et al, 1968;Somerville, 1970;Danilowicz and Ross, 1971;Jefferson et al, 1972;Macartney et al, 1973;Chesler et al, 1974;Macartney et al, 1974) and surgical reports (Ross and Somerville, 1966;McGoon et al, 1970;Kouchoukos et al, 1971;Doty et al, 1972;Somerville and Ross, 1972;Berry et al, 1974;Pacifico et al, 1974;McGoon et al, 1975;Marcelletti et al, 1976). In contrast, few pathological investigations 1223 Thiene, Bortolotti, Gallucci, Valente, and Dalla Volta have been published (Munioz-Armas et al, 1964;Edwards and McGoon, 1973;Bharati et al, 1975).…”

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confidence: 99%

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Pulmonary atresia with ventricular septal defect. Further anatomical observations.

Thiene¹,

Bortolotti²,

Gallucci³

et al. 1977

Heart

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An anatomnical study was undertaken of 25 hearts with pulmonary atresia and ventricular septal defect, giving special attention to the morphology of the pulmonary outflow tract and the nature of the arterial supply to the lungs. A common feature of all hearts studied was the presence of sixth aortic arch derivatives within the pericardial cavity. Eighteen specimens presented with pulmonary atresia with ventricular septal defect in situs solitus, with atrioventricular concordance and normally related great arteries, that is with the pulmonary artery remnant anterior and to the left of the aorta. A blind or atretic pulmonary infundibulum was observed in all but one of these cases. In the remaining 7 specimens, the atretic pulmonary trunk was posterior to the aorta.The pulmonary arterial blood supply was either through a ductus arteriosus or systemic-pulmonary anastomotic vessels. Anastomotic vessels were never observed together with a ductus, suggesting that the systemic-pulmonary vessels represent persistence of early arterial connections with the lungs when the ductus fails to develop.The result of this study when compared with our previous studies indicates that a distinction can be made between pulmonary atresia with ventricular septal defect and persistent truncus arteriosus with absent pulmonary arteries ('type IV'). The latter is considered to be a true truncus arteriosus in which the arterial connections with the pulmonary vascular bed through the sixth aortic archesfailed to develop, lack ofseptation of the cardiac outflow tracts rendering them superfluous, and thus only the early systemic-pulmonary connections persist. However, the condition is difficult or impossible to distinguish from pulmonary atresia with ventricular septal defect on clinical grounds.In the examples of pulmonary airesia with ventricular septal defect and posteriorly placed pulmonary trunk remnants, the pulmonary circulation was always supplied by the ductus arteriosus; systemic-pulmonary arteries were never seen. The mechanism producing atresia of the posteriorly positioned pulmonary infundibulum seems to be different from the form with anteriorly placed pulmonary infundibulum, as no deviation of the conal septum was seen and the ventricular septal defect was rarely a malalignment defect.

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Section: Pulmonary Circulation In Pulmonary Atresia With Ventricular mentioning

confidence: 86%

Section: Pulmonary Circulation In Pulmonary Atresia With Ventricular mentioning

confidence: 99%

Section: Pulmonary Circulation In Pulmonary Atresia With Ventricular mentioning

confidence: 99%

mentioning

confidence: 99%

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Pulmonary atresia with ventricular septal defect. Further anatomical observations.

Thiene¹,

Bortolotti²,

Gallucci³

et al. 1977

Heart

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“…The complexity of anatomic variations encountered and the vital role played by multiple, selective vessel angiography in establishing the correct anatomic features and in planning surgical treatment have been emphasized by several authors (6,(9)(10)(11). Because of the increasing sophistication of angiographic diagnosis and surgical handling (12), and because radiologic literature has dealt with small groups of patients, it seems appropriate to review our fairly extensive experience.…”

mentioning

confidence: 99%

Congenital Pulmonary Atresia with Ventricular Septal Defect: Angiographic and Surgical Correlates

Davis¹,

Fulton²,

Ritter³

et al. 1978

Radiology

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Of 181 patients with severe congenital pulmonary atresia and ventricular septal defect or "type IV truncus" (an obsolete term), all but 11% had true central pulmonary arteries. These arteries were demonstrable by large serial biplane angiograms using multiple selective injections into collateral vessels, frequent photographic subtraction, and occasional pulmonary vein-wedge angiograms. These techniques are extremely important for accurate diagnosis and in planning corrective or palliative surgery, which was done in 77% of patients with pulmonary arteries.

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Pulmonary Perfusion Defect and Bronchial Artery Collateral Blood Flow

Neches¹

1977

JAMA

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The assessment of the arterial supply to the lungs in pseudotruncus arteriosus and truncus arteriosus Type IV in relation to surgical repair

Cited by 20 publications

References 15 publications

Pulmonary atresia with ventricular septal defect. Further anatomical observations.

Pulmonary atresia with ventricular septal defect. Further anatomical observations.

Congenital Pulmonary Atresia with Ventricular Septal Defect: Angiographic and Surgical Correlates

Pulmonary Perfusion Defect and Bronchial Artery Collateral Blood Flow

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