Growth of Diminutive Central Pulmonary Arteries After Right Ventricle to Pulmonary Artery Homograft Implantation

Hibino, Narutoshi; He, Dongmei; Yuan, Feng; Yu, Jae-Hyeon; Jonas, Richard A.

doi:10.1016/j.athoracsur.2013.10.046

Cited by 24 publications

(16 citation statements)

References 23 publications

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“…The technique also gives antegrade access to the pulmonary artery tree to perform subsequent interventions such as balloon pulmonary angioplasty. This technique has been promoted by the Birmingham approach [51], and several teams favor this technique as the initial procedure for a rehabilitation strategy [30,52,53]. The RV-PA connection can be established in various ways: a transvalvar autologous pericardial patch, a Gore-Tex vascular graft [45,54], or a homograft or other valved conduits [53].…”

Section: Rehabilitationmentioning

confidence: 99%

“…This technique has been promoted by the Birmingham approach [51], and several teams favor this technique as the initial procedure for a rehabilitation strategy [30,52,53]. The RV-PA connection can be established in various ways: a transvalvar autologous pericardial patch, a Gore-Tex vascular graft [45,54], or a homograft or other valved conduits [53]. A valved conduit will reduce the volume load on the ventricle and the use of stiff conduits of fixed size such as the Hancock Dacron conduit (Medtronic, Minneapolis, MN) will maintain predicted flow while preventing the risk of dilation under pressure.…”

Section: Rehabilitationmentioning

confidence: 99%

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A Review of the Management of Pulmonary Atresia, Ventricular Septal Defect, and Major Aortopulmonary Collateral Arteries

Soquet

Barron

d’Udekem

2019

The Annals of Thoracic Surgery

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Background. The management of pulmonary atresia with ventricular septal defect (PA/VSD) and major aortopulmonary collateral arteries (MAPCAs) has significantly changed over the past 20 years. Unifocalization and rehabilitation have been described as diametrically opposed strategies. An updated review focused on the management of this complex and rare condition is needed. Methods. Articles related to PA/VSD/MAPCAs issued until December 2017 were screened. Twelve main studies published in the modern era (since 2000) were selected and analyzed. Results. Unifocalization and rehabilitation respectively focus on the mobilization of collateral arteries and the growth of native pulmonary vessels.

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Section: Rehabilitationmentioning

confidence: 99%

Section: Rehabilitationmentioning

confidence: 99%

A Review of the Management of Pulmonary Atresia, Ventricular Septal Defect, and Major Aortopulmonary Collateral Arteries

Soquet

Barron

d’Udekem

2019

The Annals of Thoracic Surgery

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“…The use of shunts in the treatment of PA/VSD/MAPCAs is not surprising from a historical standpoint, as shunting procedures were also used extensively in the early treatment of tetralogy of Fallot. Several groups continue to advocate the use of either a central shunt or right ventricle to pulmonary artery conduit as the principal method to achieve "pulmonary artery rehabilitation" [12][13][14][15][16]. The central pulmonary arteries can also be utilized in conjunction with unifocalization of MAPCAs for repair of PA/VSD/MAPCAs [6][7][8][9][10][11][17][18][19].…”

mentioning

confidence: 97%

Surgical Repair of Pulmonary Atresia With Ventricular Septal Defect and Major Aortopulmonary Collaterals With Absent Intrapericardial Pulmonary Arteries

Carrillo

Mainwaring

Patrick

et al. 2015

The Annals of Thoracic Surgery

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“…As Figure shows, the SPS patient had severe dysplastic distal and proximal PA at preoperation, and we can see the obvious development of distal and proximal PA at follow‐up. The convenience of using a transcatheter treatment to promote the growth of native PA was deemed an advantage of the RV‐PA connection by some studies, including ours. Four balloon angioplasties and one stent implantation were performed for the RV‐PA patients to expand the size and relieve stenosis of the PA.…”

Section: Discussionmentioning

confidence: 84%

“…As the unifocalization of MAPCAs was found to be a high‐risk procedure with a low patency rate and lack of growth, the systemic‐to‐pulmonary shunt (SPS) and the right ventricle to pulmonary artery (RV‐PA) connection have become the main palliative methods used for these patients. Both of these two operations have been reported to be safe and effective by other studies . However, few studies directly compare these two palliative operations.…”

Section: Introductionmentioning

confidence: 99%

Systemic‐to‐pulmonary shunt vs right ventricle to pulmonary artery connection in the treatment of pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries

et al. 2019

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Objective:The systemic-to-pulmonary shunt (SPS) and right ventricle to pulmonary artery (RV-PA) connection were evaluated to pursue the goal of rehabilitating dysplastic native PAs via establishment of antegrade blood flow. However, the application of these two palliative operations was still confusing. We compared the two operations to determine their different effects on patients who have pulmonary atresia, ventricular septal defects, and major aortopulmonary collateral arteries (MAPCAs). , 44 patients received the SPS procedure, and 54 patients received the RV-PA connection procedure; these procedures were compared based on perioperative data and follow-up data. There was no significant difference between the two groups for follow-up time (15.5 ± 11.8 vs 11.4 ± 10 months; P = .073).Results: The SPS patients had a smaller preoperative pulmonary artery index (68.57 ± 38.25 vs 112.62 ± 61.63 mm 2 /m 2 ; P < .01), more MAPCAs (2.4 ± 1.1 vs 1.8 ± 1.5; P = .045) and had a shorter intubation time (26.73 ± 27.20 vs 40.88 ± 36.93 hours; P = .045), intensive care unit stay (3.6 ± 3.9 vs 5.7 ± 5.5 days; P = .033), and hospital stay (9.9 ± 3.9 vs 14.7 ± 11.9 days; P = .014) than the RV-PA connection patients. The cumulative complete repair rate and cumulative survival rate did not differ significantly between the two groups.Conclusions: Both the SPS and the RV-PA connection could rehabilitate the PA and produce complete repair, while the SPS could achieve better early postoperative outcomes and be suitable for patients with severe dysplastic PAs and large MAPCAs. K E Y W O R D S cardiac surgery, major aortopulmonary collateral arteries, palliative operation pulmonary atresia Abbreviations: BSA, body surface area; CPB, cardiopulmonary bypass; ICU, intensive care unit; MAPCAs, major aortopulmonary collateral arteries; PA, pulmonary artery; PAI, pulmonary artery index; RV, right ventricle; SPS, systemic-to-pulmonary shunt; UCG, ultrasonic cardiogram; VSD, ventricular septal defect. Qiang Wang and Yinglong Liu contributed equally to this manuscript. Systemic-to-pulmonary shunt vs right ventricle to pulmonary artery connection in the treatment of pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries. J Card Surg. 2020;35:345-351.

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Growth of Diminutive Central Pulmonary Arteries After Right Ventricle to Pulmonary Artery Homograft Implantation

Cited by 24 publications

References 23 publications

A Review of the Management of Pulmonary Atresia, Ventricular Septal Defect, and Major Aortopulmonary Collateral Arteries

A Review of the Management of Pulmonary Atresia, Ventricular Septal Defect, and Major Aortopulmonary Collateral Arteries

Surgical Repair of Pulmonary Atresia With Ventricular Septal Defect and Major Aortopulmonary Collaterals With Absent Intrapericardial Pulmonary Arteries

Systemic‐to‐pulmonary shunt vs right ventricle to pulmonary artery connection in the treatment of pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries

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