[Surgical techniques and results of right ventricular [correction of venericular] outflow tract reconstruction with pedicled autologous tissue].
From 1987 to 2000, 44 patients underwent anatomic repair of anomalies with pulmonary outflow obstruction by using pedicled autologous tissue in reconstructing the pulmonary outflow tract. Twenty-four patients had tetralogy of Fallot with pulmonary atresia (TOF/PA), from 1.7 years to 12.9 years of age (mean 9.0 years). In the group of TOF/PA, slit-widening method was performed in 22, autologous pericardial flap was used in 1, and atrial appendage was used in 4 patients. Eight patients had transposition of the great arteries with ventricular septal defect and pulmonary stenosis (TGA type III), from 9 months to 9.2 years of age (mean 4.5 years). All of the patient with TGA type III under went direct PA-RV anastomosis (natural route non-conduit repair). Three patients had truncus arteriosus, from 1 month to 7.8 years of age (mean 4.5 years). In the group of the truncus, atrial appendage was used in 1 and direct PA-RV anstomosis was made in 2 patients. Six patients had Rastelli's conduit obstruction, from 6.6 years to 20.3 years of age (mean 13.9 years). The conduit was removed and outflow tract was reconstructed with direct PA-RV anastomosis in 5 and using atrial appendage in 1 patients. There was one hospital death (2%) and no late deaths. In 31 patients whose follow-up time exceed 5 years, 7 patients (23%) were found to have pressure gradient more than 40 mmHg at the pulmonary outflow tract. None of the patients with TGA who underwent natural route non-conduit repair developed late stenosis at the pulmonary out flow tract.
Nagata
N
N
Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, Japan.
Miyaji
K
K
Kanemoto
S
S
Yamamoto
T
T
Kitahori
K
K
D006348:Cardiac Surgical Procedures / Q000379:methods*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D011651:Pulmonary Artery / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*