Surgical experience in the rehabilitation and reimplantation of disconnected pulmonary arteries and its effectiveness in restoring pulmonary haemodynamics and function

Abstract

Our study demonstrated that, in paediatric age group, disconnected PAs can be restored with low risk and excellent outcomes even in patients with severely hypoplastic PA. Strategies to repair intracardiac defects to a single lung might not be the optimal approach.

Definition and Management of Segmental Pulmonary Hypertension

“…Several authors have used the terms “isolated PA of ductal origin” or “unilateral ductal origin of a PA” to more accurately describe this condition. Strategies to rehabilitate the isolated PA have been reported 12, 13, 14, 15, 16, 17…”

“Absent” unilateral pulmonary arteries aren't absent, but disconnected. Review of the current literature based on 4 cases

“…If such a duct is recanalised early in life, the pulmonary arteries can be resurrected and re-implanted onto the pulmonary trunk [2][3][4]. We could achieve this in two of our patients to date; with a third awaiting surgery.…”

“…Treatment may consist of primary surgery to reconnect the disconnected PA, or of initial catheterization to recanalise the arterial duct followed by surgery at a later stage [2,4]. Both strategies can achieve growth of the PA.…”

Right aortic arch with bilateral arterial duct and nonconfluent pulmonary arteries without associated cardiac defects: Prenatal diagnosis and successful postnatal treatment

“…Proper identification of PAs disconnection allowed us to manage the case at the best, maintaining flow in the disconnected PA and preventing the consequences to ipsilateral lung that would have supervened in the long term. 15 Disclosure None declared.…”

“…Because we detected the same anomaly in an 8‐year period, we suspect this malformation more common than previously thought. Proper identification of PAs disconnection allowed us to manage the case at the best, maintaining flow in the disconnected PA and preventing the consequences to ipsilateral lung that would have supervened in the long term …”