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Surgical strategies and results for repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: experience of a single tertiary center
Haydin, Sertac; Genç, Serhat Bahadir; Ozturk, Erkut; Yidiz, Okan; Gunes, Mustafa; Tanidir, Ibrahim Cansaran; Guzeltas, Alper.
Afiliação
  • Haydin, Sertac; Istanbul Saglik Bilimleri University. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital. Department of Cardiovascular Surgery. Istanbul. TR
  • Genç, Serhat Bahadir; Istanbul Saglik Bilimleri University. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital. Department of Cardiovascular Surgery. Istanbul. TR
  • Ozturk, Erkut; Istanbul Saglik Bilimleri University. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital. Department of Pediatric Cardiology. Istanbul. TR
  • Yidiz, Okan; Istanbul Saglik Bilimleri University. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital. Department of Cardiovascular Surgery. Istanbul. TR
  • Gunes, Mustafa; Istanbul Saglik Bilimleri University. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital. Department of Cardiovascular Surgery. Istanbul. TR
  • Tanidir, Ibrahim Cansaran; Istanbul Saglik Bilimleri University. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital. Department of Pediatric Cardiology. Istanbul. TR
  • Guzeltas, Alper; Istanbul Saglik Bilimleri University. Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital. Department of Pediatric Cardiology. Istanbul. TR
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;35(4): 445-451, July-Aug. 2020. tab, graf
Article em En | LILACS, SES-SP | ID: biblio-1137300
Biblioteca responsável: BR1.1
ABSTRACT
Abstract

Objective:

To evaluate surgical management and results of patients with pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries (PA/VSD/MAPCAs).

Methods:

We reviewed a consecutive series of patients with PA/VSD/MAPCAs between January 2012 and October 2018. Study patients were separated into Group A, efficient MAPCAs; Group B, hypoplastic MAPCAs; Group C, severe hypoplastic MAPCAs at all divisions; and Group D, distal stenosis at most MAPCAs divisions.

Results:

Thirty-six patients were included in the study. Median age at operation time was 5.5 months (2-110 months), median weight was 8 kg (2.5-21 kg), and median number of MAPCAs was three (1-6). In Group A, 14 patients underwent single-stage total correction (TC); in Group B, 18 patients underwent unifocalization and central shunting; and in Group C, four patients had aortopulmonary window creation and collateral ligation. No patient was placed in Group D. Seventy percent of patients (n=25) had the TC operation. Early mortality was not seen in Group A, but the other two groups had a 13.6% mortality rate. At the follow-up, three patients had reintervention, two had new conduit replacement, and one had right ventricular outflow tract reconstruction.

Conclusion:

Evaluating patients with PA/VSD/MAPCAs in detail and subdividing them is quite useful in determining the appropriate surgical approach. With this strategy, TC can be achieved in most patients. Single-stage TC is better than other surgical methods due to its lower mortality and reintervention rates. Care should be taken in terms of early postoperative intensive care complications and reintervention indications during follow-ups.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS / SES-SP Assunto principal: Atresia Pulmonar / Defeitos dos Septos Cardíacos / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Observational_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Rev. bras. cir. cardiovasc Assunto da revista: CARDIOLOGIA / CIRURGIA GERAL Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Turquia País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS / SES-SP Assunto principal: Atresia Pulmonar / Defeitos dos Septos Cardíacos / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Observational_studies Limite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Rev. bras. cir. cardiovasc Assunto da revista: CARDIOLOGIA / CIRURGIA GERAL Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Turquia País de publicação: Brasil