Truncus Arteriosus With Major Aortopulmonary Collateral Arteries

Fujiwara, Keiichi; Yoshizawa, Kosuke; Kato, Otohime; Sakazaki, Hisanori

doi:10.1016/j.athoracsur.2018.12.051

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…DSCT could provide detailed and comprehensive information about them through powerful postprocessing techniques. With regards to aortopulmonary collateral arteries, accurate preoperative evaluation of these collateral arteries could be helpful in surgical planning [5,25]. DSCT could easily identify the number, origin, branching pattern, and supplied lung lobes.…”

Section: Discussionmentioning

confidence: 99%

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Low-Dose Dual-Source Computed Tomography for Evaluating Persistent Truncus Arteriosus Associated with Cardiovascular Anomalies: Comparison with Transthoracic Echocardiography

Tang

Wang

Shi

et al. 2021

Preprint

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BackgroundTo assess the morphological features of persistent truncus arteriosus (PTA) on low-dose dual-source computed tomography (DSCT) and compare its diagnostic value for associated cardiovascular anomalies with that of transthoracic echocardiography (TTE).Methods:Twenty-four PTA patients were enrolled in this retrospective study. The types of PTA, diameters of the truncus artery (TA), main pulmonary artery (MPA), right pulmonary artery (RPA), left pulmonary artery (LPA), and ventricular septal defect (VSD) on DSCT were recorded. Besides, all associated cardiovascular abnormalities were assessed. The diagnostic performance of DSCT and TTE for associated anomalies were compared. The effective doses of DSCT were calculated.Results:Four types were found: type A1(n=13/24, 54.17%), type A2(n=7/24, 29.16%), type A3（n=3/24, 12.50%）and type A4(n=1/24,4.17%). The mean diameter of VSD, TA, MPA, RPA, and LPA was 1.47±0.56cm, 3.92±1.56cm, 2.27±1.65cm, 1.48±0.74cm and 1.38±0.66cm, respectively. 78 associated cardiovascular anomalies were confirmed. The most common associated abnormalities were VSD (100%), right-sided aortic arch (33.33%) and aortopulmonary collateral vessels (29.17%). Although TTE was better at diagnosing intracardiac anomalies (accuracy:99.17% vs. 95%; sensitivity: 97.06% vs. 88.24%; specificity: 100% vs. 97.67%), DSCT had an advantage in diagnosing the associated cardiovascular abnormalities (accuracy: 98.61% vs. 96.07%; sensitivity: 94.87% vs. 82.05%; specificity: 99.44% vs. 99.15%). The estimated mean effective doses was 0.98±0.37mSv (＜1mSv). Conclusions:Low-dose DSCT could accurately confirm the morphological features of PTA. Compared to TTE, low-dose DSCT is a better diagnostic tool for associated cardiovascular abnormalities. Combining with TTE will be beneficial to provide more accurate information for clinical interventions.

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Section: Discussionmentioning

confidence: 99%

“…Thus, the accurate preoperative diagnosis and description of anatomy are crucial. Moreover, the associated anomalies, especially the coronary and pulmonary artery abnormalities, aortopulmonary collateral arteries, are associated with the surgical process and mortality [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Low-Dose Dual-Source Computed Tomography for Evaluating Persistent Truncus Arteriosus Associated with Cardiovascular Anomalies: Comparison with Transthoracic Echocardiography

Tang

Wang

Shi

et al. 2021

Preprint

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“…The type A3 is seen in approximately 10% of the PTA spectrum 3 . The optimal strategy and practical techniques for treating this relatively rare entity remains controversial 4‐6 . In particular, it has been reported that repair was rather challenging in patients in whom the right or the left PA arose from the subclavian artery or the contralaterally located descending aorta 1 .…”

Section: Commentmentioning

confidence: 99%

“…3 The optimal strategy and practical techniques for treating this relatively rare entity remains controversial. [4][5][6] In particular, it has been reported that repair was rather challenging in patients in whom the right or the left PA arose from the subclavian artery or the contralaterally located descending aorta. 1 On top of such an atypical course of the left PA, the presence of a bulky PLSVC made us hesitate a primary repair in our small neonate.…”

Section: Commentmentioning

confidence: 99%

Is two‐staged repair for truncus arteriosus type A3 unpractical?

et al. 2020

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Background A complex and rare form of persistent truncus arteriosus needs careful attention when choosing the optimal strategy for repair. Aim of the Study We herein describe our surgical strategy of a small infant having this malformation concomitantly with right aortic arch, unusual pulmonary artery branching and a left superior vena cava. Methods The patient underwent initially bilateral pulmonary arterial banding followed by the Rastelli type definitive repair. The pulmonary arteries were unified in front of the left superior vena cava, and the right ventricular outflow tract was readily reconstructed. Results The patient is doing well with an excellent hemodynamic status. Conclusions: We considered the two‐stage approach was sensible in this particular patient.

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“…Згодом у віці 2,7 року було проведено уніфокалізацію великих аорто-легеневих колатеральних артерій справа та накладання системно-легеневого шунта. Успішну РК виконали у віці 5 років [3].…”

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Ductus Arteriosus Stenting as a Method of Palliative Treatment of Truncus Arteriosus Type A3: Literature Review and Clinical Case

Hura,

Mykhailovska,

Motrechko

et al. 2023

ujcvs

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Introduction. Van Praagh A3 variant of truncus arteriosus (TA A3) is a condition when the one pulmonary artery branch origins from the TA, the other is filled through the patent ductus arteriosus (PDA). PDA constriction in the early neonatal period can cause absence of blood supply to the one pulmonary artery branch. To prevent this, prolonged infusion of prostaglandin E1, PDA stenting or systemic-to-pulmonary shunt are used. These methods allow to postpone total repair (TR) and reduce mortality risks associated with neonatal period. The aim. To analyze research papers dedicated to endovascular approach of TA A3 staged treatment and to present our own experience. Materials and methods. We conducted a systematic literature search and analyzed various options for the TA A3 staged treatment. After the review, we used endovascular approach as the first stage of treatment in our clinical case. We studied a newborn weighing 4 kg with TA A3 (left pulmonary artery branch origins from the non-coronary sinus of the truncal valve, right pulmonary artery branch filling through the PDA). Nakata index was 83 mm2/m2. McGoon ratio was 1. We decided to perform PDA stenting with the aim of postponing surgical correction until the patient’s optimal age and weight. Discussion. In total, the number of publications about TA A3 staged treatment is limited. Most institutions prefer TA A3 staged treatment in newborns, because it is associated with a lower risk of complications than early TR. In our clinical case, the first step was PDA stenting. The staged approach allowed us to perform TR with a good result at the age of 3 months. Before TR, Nakata index and McGoon ratio were increased to 248 mm2/m2 and 1.9, respectively. Conclusions. The current trend of TA A3 repair has few different options of staged treatment. Staged approach helps to get out of the newborn period and achieves the optimal condition for TR. Our patient successfully received PDA stenting as the first stage of treatment, which created conditions for the pulmonary artery branches growth. The second stage was TR with good long-term results. After analyzing the publications, we noted that the use of endovascular PDA stenting is a good and safe alternative to surgical palliative treatment.

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Truncus Arteriosus With Major Aortopulmonary Collateral Arteries

Cited by 4 publications

References 7 publications

Low-Dose Dual-Source Computed Tomography for Evaluating Persistent Truncus Arteriosus Associated with Cardiovascular Anomalies: Comparison with Transthoracic Echocardiography

Low-Dose Dual-Source Computed Tomography for Evaluating Persistent Truncus Arteriosus Associated with Cardiovascular Anomalies: Comparison with Transthoracic Echocardiography

Is two‐staged repair for truncus arteriosus type A3 unpractical?

Ductus Arteriosus Stenting as a Method of Palliative Treatment of Truncus Arteriosus Type A3: Literature Review and Clinical Case

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