Pulmonary circulation in pulmonary atresia associated with the asplenia cardiac syndrome.
OBJECTIVE
The goal of this study was to determine the patterns of the pulmonary circulation in patients with pulmonary atresia and asplenia.


BACKGROUND
The asplenic cardiac syndromes characteristically have complex cardiac anomalies including pulmonary stenosis or atresia. Definition of the pulmonary artery circulation and pulmonary venous connections is needed for consideration of surgical procedures.


METHODS
In 35 patients, the sources of pulmonary blood flow, anatomic features of pulmonary arteries and pulmonary venous connections were determined from angiograms or autopsy specimens.


RESULTS
The main pulmonary artery was absent or hypoplastic in 91% of patients; most had a ductus arteriosus. The right and left pulmonary arteries were confluent in 90% and usually of normal size (right 71%, left 63%). Total anomalous pulmonary venous connections were present in 38%.


CONCLUSIONS
The anatomic features of the pulmonary arteries in pulmonary atresia associated with the asplenic cardiac syndrome are usually favorable for palliative surgical procedures. Total anomalous pulmonary venous connection may exist as a complicating factor.
Vitiello
R
R
Department of Pediatrics, University of Minnesota, Minneapolis.
Moller
J H
JH
Marino
B
B
Vairo
U
U
Edwards
J E
JE
Titus
J L
JL
D002648:Child; D002675:Child, Preschool; D004374:Ductus Arteriosus, Patent / Q000473:pathology; D005260:Female; D006330:Heart Defects, Congenital / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D011651:Pulmonary Artery / Q000002:abnormalities*; D011664:Pulmonary Valve / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*; D013154:Spleen / Q000002:abnormalities*; D013577:Syndrome