[The indication and effects of palliative right ventricular outflow tract reconstruction for tetralogy of Fallot with pulmonary atresia].
Palliative right ventricular outflow reconstruction (RVOT) in 5 cases with tetralogy of Fallot with valvular pulmonary atresia and 5 cases with truncal pulmonary atresia were studied regarding indication and postoperative development of pulmonary artery. In 4 cases with valvular atresia, RVOT was performed following previous palliation such as Blalock-Taussig shunt, and resulted in improvement in clinical symptoms and in significant increase in postoperative PA-index from 105.4 mm2/m2 before operation to 159.4 mm2/m2. In one case, RVOT was performed as the first stage palliation and symmetrical development of pulmonary arteries were observed. All underwent successful total correction later. However, in 5 cases with the truncal atresia, 2 died after RVOT and postoperative development of pulmonary artery was insignificant. RVOT is indicated for cases with poor pulmonary arterial development despite of palliation, and in future, RVOT as an initial palliation will be indicated in infants with hypoplastic pulmonary artery.
Tezuka
M
M
Department of Pediatric Cardiovascular Surgery, Tokyo Women's Medical College, Japan.
Imai
Y
Y
Kurosawa
H
H
Nakae
S
S
Nakata
S
S
Takao
A
A
D002648:Child; D002675:Child, Preschool; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D010166:Palliative Care / Q000379:methods; D011651:Pulmonary Artery / Q000254:growth & development; D011664:Pulmonary Valve / Q000002:abnormalities*; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*