Infants with functionally single ventricle who require a modified Blalock-Taussig shunt can have stenosis at the ductal insertion site on the pulmonary artery (PA), the so-called ductal-associated PA coarctation. We hypothesized that central PA plasty with resection of the ductal tissue on the PA during the first palliation would prevent PA coarctation and obtain well-balanced PA for Fontan operation. We performed this strategy on 40 consecutive patients (from 1998 to 2012, Age 38.4 ± 24.7 day [17 neonates], body weight 3.5 ± 0.8 kg, heterotaxy n = 27). The mean Nakata index (mm2/m2) before bidirectional cavopulmonary shunt was 230.7 ± 101.7 without pulmonary stenosis. The PA diameter ratio and lung perfusion ratio (nonshunt side and/or shunt side) were 0.93 ± 0.25 and 0.9 ± 0.2, respectively. This strategy may improve clinical outcomes on functional single ventricle patients with increased risk of stenosis from pulmonary coarctation, with avoidance of an unbalanced pulmonary vascular bed.
CITATION STYLE
Sakamoto, K. (2020). Primary Central Pulmonary Artery Plasty for Ductal-Associated Pulmonary Artery Coarctation. Operative Techniques in Thoracic and Cardiovascular Surgery, 25(2), 58–73. https://doi.org/10.1053/j.optechstcvs.2020.04.004
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