The Lecompte Maneuver for Relief of Airway Compression in Absent Pulmonary Valve Syndrome

Nölke, Lars; Azakie, Anthony; Anagnostopoulos, Petrous V.; Alphonso, Nelson; Karl, Tom R.

doi:10.1016/j.athoracsur.2005.12.001

Cited by 36 publications

(22 citation statements)

References 28 publications

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“…Treatment for major airway obstruction associated with congenital heart defects in infancy is variable [4][5][6][7][8]. In our case, the stretched and dilated right pulmonary artery was considered to be a conclusive cause of airway obstruction as follows.…”

Section: Discussionmentioning

confidence: 97%

“…However, the procedure is not new at all and has already been adopted for the treatment of absent pulmonary valve syndrome [4]. It is commonly used in cases of a pulmonary artery sling.…”

Section: Discussionmentioning

confidence: 99%

“…Abnormalities in the vascular structure such as a vascular ring, an aberrant innominate artery or right aortic artery, or a massively dilated pulmonary artery cause tracheobronchial compression [3,4]. Dilation of a pulmonary artery may be caused not only by a left-to-right shunt but also by uncontrolled or unbalanced pulmonary arterial blood flow.…”

Section: Introductionmentioning

confidence: 98%

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Translocation of dilated pulmonary artery for relief of bronchial compression associated with ventricular septal defect

Nomura

Asano

Mizuno

et al. 2007

European Journal of Cardio-Thoracic Surgery

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Bronchial compression due to a dilated pulmonary artery is a troublesome problem in the surgical management of infants or children with congenital heart disease. We experienced an infantile case of ventricular septal defect and prolonged respiratory insufficiency caused by right bronchial compression and left pulmonary hypoplasia. Anterior translocation of the dilated right pulmonary artery and intracardiac repair succeeded in relieving the bronchial compression and improving left pulmonary function. We advocate that this procedure is useful for bronchial compression with congenital heart disease and maldevelopment of the lung.

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Section: Discussionmentioning

confidence: 97%

“…However, the procedure is not new at all and has already been adopted for the treatment of absent pulmonary valve syndrome [4]. It is commonly used in cases of a pulmonary artery sling.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Translocation of dilated pulmonary artery for relief of bronchial compression associated with ventricular septal defect

Nomura

Asano

Mizuno

et al. 2007

European Journal of Cardio-Thoracic Surgery

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“…Osim ova dva najčešća oblika, u literaturi se opisuju bolesnici s drugim pridruženim kardijalnim abnormalnostima kao što su atrezija trikuspidalne valvule, dvostruki izlaz iz desne klijetke, transpozicija velikih krvnih žila, abnormalnosti grananja plućne arterije te njihove različite kombinacije. 5,8,11,12 Zbog relativno malog broja bolesnika o učestalosti pojedinih tipova raspravlja se 1,7,11 ili se kaže da je nepoznata. 13 Dvoje od naših bolesnika imalo je pri- Zaključak Upravo zahvaljujući razvoju fetalne kardiologije i spomenutim spoznajama iz literature, i u našim se uvjetima APVS može uspješno liječiti ako se držimo početnih smjernica: ranog prepoznavanja sindroma (prenatalna dijagnostika), rane kardiokirurške intervencije (ligatura duktusa i ugradnja valvuliranog provodnika između desne klijetke i plućne arterije) te plikacije aneurizmatski proširenih plućnih arterija i oslobađanja dišnih putova od njihova pritiska (LeCompteov manevar).…”

Section: Prikaz Bolesnikâunclassified

“…Unatoč mnogim pretpostavkama sama etiologija dilatacije plućnih arterija nije razjašnjena iako je tijekom povijesti predloženo više različitih mehanizama -od histoloških poremećaja građe plućnih arterija do poststenotičke dilatacije zbog turbulentnog toka krvi. 5,7,11,16,17 U novije vrijeme sve više radova govori o poremećaju fetalne cirkulacije zbog povećanog ili smanjenog protoka kroz Botallov duktus kao osnovnom patogenetskom mehanizmu nastanka navedenih promjena. 4,6,8,10,12,14,15,18 APVS se većinom javlja sporadično, no u određenog broja tetralogijskih oblika nađena je delecija 22q11.2, a u vrlo malom broju izoliranih oblika APVS-a nađena je delecija 18q, 1,7,8,11 kod nekih već u prenatalnoj dobi.…”

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Congenital Absence of the Pulmonary Valve and Dysfunction of Fetal Duct – Source of Wide Spec-Trum of Cardiovascular Pathology

2019

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Goal: Congenital absent pulmonary valve with dysfunction and/or atypical ductus Botalli dysfunction (APV/DBD) may cause a wide spectrum of heart anomalies. The goal of this study is to describe the clinical appearance, present prenatal (fetal) and postnatal diagnostic methods, course, and outcome of this rare entity which is often overlooked. Methods and results: We present four patients, all with the entity manifested as an absent (dysfunctional) pulmonary valve with various stenosis and insufficiency degrees and as a pathological enlargement of MPA and RPA dilatation, with consecutive pathological impression on large airways and consequently respiratory insufficiency with lethal outcome as a possibility. In at least three patients there was also atypical pathology of DB, and wide spectrum of pathologic changes in the right cavities of the heart: RV hypertrophy, RA enlargement, non-compaction cardiomyopathy and tricuspid insufficiency. In two patients the defect was diagnosed in utero. In these two patients we followed the guidelines suggested in recent literature: 1. prenatal diagnosis as an imperative, 2. early cardiosurgical correction with implantation of valved RV-PA conduit, 3. plication of pulmonary artery or LeCompte manoeuvre in order to relieve the bronchial compression. Two patients died because of right ventricular failure or respiratory insufficiency due to airway compression. Deletion syndrome (22q11.2 or 18q deletions), mentioned in etiopathogenic consideration as a part of the conotruncal anomalies spectrum, was not determined in any of the patients. Surviving patients remain under constant supervision of pediatric cardiologists. Conclusion: Congenital pulmonary valve dysfunction and/or atypical DB dysfunction in fetal period are a possible cause of dysplasia of pulmonary valve with consequent stenosis and insufficiency, as well as a spectrum of anomalies in right cardiac cavities and valves. Prerequisite for successful treatment is early (prenatal) diagnosis of the syndrome, early cardiosurgical intervention (ductus ligation and valved conduit RV-PA implantation), and plication of aneurismatic dilated pulmonary arteries with the aim to relieve the airways of their compression. The spectrum of changes is better recognised if one considers the theoretical assumption about a possible disorder of migration of neuroectoderm into the mesenchymal substructure of the heart, same as with other conotruncal anomalies.

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Tetralogy of Fallot with Absent Pulmonary Valve

Koh¹,

Morell²,

Chrysostomou³

et al. 2020

Critical Care of Children With Heart Disease

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The Lecompte Maneuver for Relief of Airway Compression in Absent Pulmonary Valve Syndrome

Cited by 36 publications

References 28 publications

Translocation of dilated pulmonary artery for relief of bronchial compression associated with ventricular septal defect

Translocation of dilated pulmonary artery for relief of bronchial compression associated with ventricular septal defect

Congenital Absence of the Pulmonary Valve and Dysfunction of Fetal Duct – Source of Wide Spec-Trum of Cardiovascular Pathology

Tetralogy of Fallot with Absent Pulmonary Valve

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