Complex Pulmonary Artery Reconstruction

Abstract

Complex Pulmonary Artery Reconstruction evolved through our long-term clinical experience in the surgical management of patients with major aortopulmonary collateral arteries. A midline sternotomy approach, utilizing novel techniques for exposure and mobilization, enables access to the distal pulmonary artery tree to the segmental and subsegmental levels. This allows reconstructive procedures to address both discrete stenoses and areas of long-segment hypoplasia, to reduce pulmonary hypertension and improve and/or preserve right ventricular function. We have utilized this technique in over 70 patients, with our most recent analysis demonstrating one operative mortality, no operative reintervention, and improvement in right to left ventricular pressure ratio from 0.94 (0.72-1.30) to 0.36 (0.19-0.54) with durable 4 ± 3 year follow-up.