title: Reconstruction of the pulmonary posterior wall using in situ autologous tissue for the treatment of pulmonary atresia with ventricular septal defect.
abstract: BACKGROUND
  To evaluate the early and mid-term results of pulmonary trunk reconstruction using a technique in which autogenous tissue is preserved in situ in pulmonary atresia patients with a ventricular septal defect (PA-VSD).
  
  
  METHODS
  The pulmonary artery was reconstructed using autogenous tissue that had been preserved in situ and a bovine jugular venous patch in 24 patients who were diagnosed with PA-VSD (the observation group). The traditional operation using a bovine jugular venous conduit was performed in 40 other cases of PA-VSD (the control group).
  
  
  RESULTS
  In the observation group, all patients survived and recovered successfully without complications. Follow-up echocardiography 2-10 years after the procedure showed that the reconstructed right ventricular outflow tract (RVOT) and pulmonary artery were patent, showing no evidence of flow obstruction. Only mild regurgitation of the bovine jugular vein valve was observed. In the control group, early postoperative death occurred in two cases. Another two patients had obstruction of the anastomotic stoma and underwent conduit replacement surgery within 2 weeks of the initial procedure. During the 2-10 years of follow-up care, six patients presented with valvular stenosis of the BJVC, with a pressure gradient of more than 50 mmHg.
  
  
  CONCLUSIONS
  The technique for preserving autogenous tissue to reconstruct the pulmonary posterior wall is a satisfactory method for treating PA-VSD.
authors.affiliation: Department of the cardiovascular surgery, the Second Xiangya Hospital, Central South University, Middle Renmin Road 139, 410011, Changsha, China.
authors.forename: Chengming
authors.initials: C
authors.lastname: Fan
authors.affiliation: Department of the cardiovascular surgery, the Second Xiangya Hospital, Central South University, Middle Renmin Road 139, 410011, Changsha, China.
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of the cardiovascular surgery, the Second Xiangya Hospital, Central South University, Middle Renmin Road 139, 410011, Changsha, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Xiong
authors.affiliation: Department of the cardiovascular surgery, the Second Xiangya Hospital, Central South University, Middle Renmin Road 139, 410011, Changsha, China.
authors.forename: Ni
authors.initials: N
authors.lastname: Yin
authors.affiliation: Department of the cardiovascular surgery, the Second Xiangya Hospital, Central South University, Middle Renmin Road 139, 410011, Changsha, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of the cardiovascular surgery, the Second Xiangya Hospital, Central South University, Middle Renmin Road 139, 410011, Changsha, China.
authors.forename: Mi
authors.initials: M
authors.lastname: Tang
authors.affiliation: Department of the cardiovascular surgery, the Second Xiangya Hospital, Central South University, Middle Renmin Road 139, 410011, Changsha, China. yjf19682005@sina.com.
authors.forename: Jinfu
authors.initials: J
authors.lastname: Yang
mesh_terms: D000328:Adult; D000818:Animals; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002417:Cattle; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006343:Heart Septal Defects / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D007601:Jugular Veins / Q000637:transplantation*; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D018633:Pulmonary Atresia / Q000175:diagnosis / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Congenital heart disease; In situ autogenous tissue; Pulmonary atresia; Pulmonary reconstruction