[Right ventricular outflow tract reconstruction using monocusp valved outflow patch for pulmonary atresia with ventricular septal defect: influence of the presence of major aorto-pulmonary collateral arteries].
We have preferably utilized monocusp valved outflow patch (MVOP) for right ventricular outflow tract (RVOT) reconstruction in pulmonary atresia with ventricular septal defect (PA + VSD). The purpose of this study was to evaluate the influence of the presence of major aorto-pulmonary collateral arteries (MAPCAs) on probability of MVOP reconstruction and development of RVOT restenosis in midterm. 49 patients underwent complete repair (either MVOP reconstruction or Rastelli procedure) of PA + VSD in our service. These patients were divided into 2 groups: group 1; 21 patients with MAPCAs, group 2; 28 patients without MAPCAs. There was one operative death (group 1). The probably of MVOP reconstruction was similar between group 1 and group 2 (71 vs 79%, p = 0.57, chi 2 test). Follow-up was completed for 48 survivors with the period ranged 3-108 months (mean 47 months). In group 1, one patient died suddenly at home 10 months after surgery. For 47 long-term patients, the ratio of freedom from RVOT restenosis was 72% (95% CI: 52-92%, Kaplan-Meier method) at 5 year. There was no difference between 2 groups (group 1; 73%, 95% CI: 45-100%, group 2; 74%, 95% CI: 48-99%, respectively, p = 0.85 by Log-Rank test). The presence of MAPCAs in PA + VSD was not a risk factor for either the probably of MVOP reconstruction or development of RVOT restenosis in midterm.
Hisamochi
K
K
Department of Cardiovascular Surgery, Okayama University Medical School, Okayama, Japan.
Ishino
K
K
Kawada
M
M
Ohshima
Y
Y
Aoki
A
A
Arai
S
S
Sano
S
S
D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003097:Collateral Circulation; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D018633:Pulmonary Atresia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011652:Pulmonary Circulation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012039:Regional Blood Flow