The internal mammary artery as a shunt in a noncyanotic infant with hemitruncus: surgical and anesthetic management.
The internal mammary artery (IMA) has been used as a systemic-to-pulmonary artery shunt in selected patients with congenital heart disease. Growth and development of hypoplastic pulmonary arteries have been described. We discuss the surgical and anesthetic management of an infant with an atretic-thrombosed right pulmonary artery originating from the ascending aorta in whom the IMA was used to create a systemic-to-pulmonary artery shunt after failure of a previous shunt and later successful pulmonary artery reconstruction. The IMA should be considered as an alternative conduit in patients requiring a systemic-to-pulmonary artery shunt for growth of pulmonary arteries.
Division of Cardiothoracic Surgery, Department of Surgery, St. Christopher's Hospital for Children, 3601 A St, Philadelphia, PA 19134; Drexel University College of Medicine, Philadelphia, PA 19102. Electronic address: Vicki.mahan@tenethealth.com.
Vicki L
VL
Mahan
Division of Cardiothoracic Surgery, Department of Surgery, St. Christopher's Hospital for Children, 3601 A St, Philadelphia, PA 19134; Drexel University College of Medicine, Philadelphia, PA 19102.
Randy M
RM
Stevens
Division of Cardiology, Department of Pediatrics, St. Christopher's Hospital for Children, 3601 A St, Philadelphia, PA 19134; Drexel University College of Medicine, Philadelphia, PA 19102.
Cesar I
CI
Mesia
Department of Anesthesiology, St. Christopher's Hospital for Children, 3601 A S, Philadelphia, PA 19134; Drexel University College of Medicine, Philadelphia, PA 19102.
Roy E
RE
Schwartz
Division of Cardiothoracic Surgery, Department of Surgery, St. Christopher's Hospital for Children, 3601 A St, Philadelphia, PA 19134; Drexel University College of Medicine, Philadelphia, PA 19102.
Achintya N
AN
Moulick
D000758:Anesthesia / Q000379:methods*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008323:Mammary Arteries / Q000601:surgery*; D011651:Pulmonary Artery / Q000601:surgery*
CHD; Congenital heart disease; Pulmonary arteries