Surgical management of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: a protocol-based approach.
Historically, outcomes of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals have been quite poor. Over the past 15 years, our group has strived to apply a consistent surgical strategy for this lesion based on two guiding principles: early unifocalization of all important collaterals; and the early establishment of a low-pressure pulmonary arterial bed, preferably using simultaneous intracardiac repair. We describe a management protocol that has been developed to handle the highly variable nature of pulmonary blood flow observed with this lesion.
Malhotra
Sunil P
SP
Departments of Surgery and Pediatrics, Congenital Heart Center, University of Florida, Gainesville, FL, USA.
Hanley
Frank L
FL
D000465:Algorithms; D001013:Aorta, Thoracic / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011651:Pulmonary Artery / Q000601:surgery; D018633:Pulmonary Atresia / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods