title: Surgical results of anomalous origin of the right pulmonary artery from the ascending aorta including reoperation for infrequent complications.
abstract: BACKGROUND
  We evaluated the results of surgery for an anomalous origin of the right pulmonary artery from the ascending aorta.
  
  
  METHODS
  From August 1986 to December 2005, 8 children (6 neonates) aged 7 to 180 days (mean, 35 +/- 59 days) with anomalous origin of the right pulmonary artery from the ascending aorta underwent surgical repair at our institute. All except one child, who had the distal form, had the proximal form. Cardiac catheterization showed that the left pulmonary artery to systemic pressure ratio was 1.0 or more. Surgery was performed by direct anastomosis in 7 patients and by graft interposition in 1.
  
  
  RESULTS
  There were no operative or late deaths. All patients postoperatively underwent cardiac catheterization that showed decreased left pulmonary artery to systemic pressure ratio ranging from 0.2 to 0.6. Follow-up periods ranged from 2 months to 13 years. We undertook reoperations for two infrequent postoperative causes. One patient exhibited significant supravalvar aortic stenosis and required patch enlargement of the ascending aorta 3 years after operation. The other patient (with the distal form) needed a reoperation after 1 month because of progressive stenosis at the anatomic site. Graft interposition was performed, and histopathologic examination showed that the tissue from the stenotic region looked like that of a ductus.
  
  
  CONCLUSIONS
  We undertook surgical repair for anomalous origin of the right pulmonary artery from the ascending aorta. Pulmonary hypertension was improved in all patients. Careful follow-up was necessary to detect supravalvar aortic and anastomotic stenosis early and late after operation.
authors: Department of Cardiovascular Surgery, Kyushu Koseinenkin Hospital, Kitakyushu, Japan. n-c.kaji@f6.dion.ne.jp
authors: Noriyoshi
authors: N
authors: Kajihara
authors: Yutaka
authors: Y
authors: Imoto
authors: Masato
authors: M
authors: Sakamoto
authors: Yukie
authors: Y
authors: Ochiai
authors: Meikun
authors: M
authors: Kan-o
authors: Kunitaka
authors: K
authors: Joo
authors: Mamie
authors: M
authors: Watanabe
authors: Tetsuji
authors: T
authors: Yuge
authors: Toshihide
authors: T
authors: Asou
authors: Yuko
authors: Y
authors: Takeda
authors: Akira
authors: A
authors: Sese
mesh_terms: D000792:Angiography / Q000379:methods; D001013:Aorta, Thoracic / Q000002:abnormalities*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods; D002315:Cardiopulmonary Bypass; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D011300:Preoperative Care / Q000379:methods; D011651:Pulmonary Artery / Q000002:abnormalities*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*