MyMedR

Biologic valved conduits in infants

Corno AF

Ann Thorac Surg, 2014 May;97(5):1853.

PMID: 24792290 DOI: 10.1016/j.athoracsur.2013.12.010

Matched MeSH terms: Pulmonary Artery/surgery*

Surgical management of patent ductus arteriosus with endocarditis

Kareem BA, Kamarulzaman H, Koh GT

Ann Thorac Surg, 2010 Nov;90(5):1703-5.

PMID: 20971300 DOI: 10.1016/j.athoracsur.2010.04.105

A 9-year-old boy with patent ductus arteriosus complicated by infective endocarditis had not responded to antibiotic therapy and was referred to our institution. He had persistent fever and a chest roentgenogram demonstrated the presence of left lung pneumonic consolidation. An echocardiogram showed the presence of large vegetation in the pulmonary artery at the ductal opening. We successfully performed an open ductal ligation with the aid of cardiopulmonary bypass through a sternotomy and proceeded to resect the vegetation. We completed the procedure with reconstruction of the pulmonary artery. The postoperative course was uneventful. The patient was discharged after a week.

Matched MeSH terms: Pulmonary Artery/surgery

Fulltext eComment. Paradigm shift in surgery for massive pulmonary embolism: if not now then when?

Sachithanandan A

Interact Cardiovasc Thorac Surg, 2013 Aug;17(2):246.

PMID: 23868961 DOI: 10.1093/icvts/ivt274

Matched MeSH terms: Pulmonary Artery/surgery*

Fulltext Severe and fatal postoperative bronchospasm in a child with a pulmonary artery sling

Norzila MZ, Azizi BH, Mazeni A, Ahmad S, Devadass P, Lokman S

Med J Malaysia, 1994 Jun;49(2):182-4.

PMID: 8090102

We report a case of left pulmonary artery sling in a child who also had duodenal atresia. He was admitted for respiratory failure requiring prolonged respiratory support due to a bronchiolitis-like illness at two months of age. Diagnostic procedures confirmed the presence of left pulmonary artery sling. He had a corrective procedure which relieved the compression. However postoperatively he had intermittent episodes of severe bronchospasm in addition to a persistent airway obstruction. Finally one such episode of severe bronchospasm did not respond to medical and resuscitative therapy and the baby succumbed. To our knowledge no case of left pulmonary artery sling has been described previously in a Malaysian child. This case also highlights the postoperative airway problems that may be encountered.

Matched MeSH terms: Pulmonary Artery/surgery

Fulltext Anomalous right pulmonary artery from aorta, surgical approach case report and literature review

Alhawri K, Alakhfash A, Alqwaee A, HassabElnabi M, Ahmed F, Alhawri M, et al.

J Card Surg, 2021 Aug;36(8):2890-2900.

PMID: 34047395 DOI: 10.1111/jocs.15618

BACKGROUND: Anomalous origin of one pulmonary artery from the aorta is a rare congenital anomaly affecting the right pulmonary artery more than the left. These patients are at risk for the early development of significant pulmonary hypertension. Early surgical treatment has been proven safe with excellent results. The surgical approach and technique is challenging and should be decided ahead before the patient to surgery. Different techniques were described including direct reimplantation, conduit interposition, aortic ring flap.

AIM: We present a neonate with anomalous origin of the right pulmonary artery from the aorta and discuss the surgical technique and complications in the literature.

Matched MeSH terms: Pulmonary Artery/surgery

A rare complication of myocardial ischaemia following single-stage repair in a case of Berry syndrome

Duyen MD, Haranal MY, Dillon J, Sivalingam S

Interact Cardiovasc Thorac Surg, 2020 10 01;31(4):576-577.

PMID: 32772077 DOI: 10.1093/icvts/ivaa126

Berry syndrome is a rare congenital cardiac lesion consisting of a distal aortopulmonary window, the aortic origin of the right pulmonary artery (PA), intact ventricular septum and an interrupted or hypoplastic aortic arch. Different repair techniques have been described in the literature. We report a case of Berry syndrome, in whom myocardial ischaemia developed following direct implantation of the right PA to the main PA, which was resolved using an interposition tube graft.

Matched MeSH terms: Pulmonary Artery/surgery*

[Bidirectional Glenn shunt without cardiopulmonary bypass]

Maeba S, Nemoto S, Hamdan L, Okada T, Azhari M

Kyobu Geka, 2006 Nov;59(12):1075-8.

PMID: 17094543

From April 2002 to March 2005, 18 patients having undergone bidirectional Glenn shunt (BDG) without cardiopulmonary bypass (CPB) [off-pump BDG] were retrospectively reviewed. During BDG anastomosis, a temporary bypass was established between superior vena cava (15) or innominate vein (3) and main pulmonary artery (16) or right atrium (2). Hemodynamics and oxygenation were maintained well throughout the temporary bypass time. There was no emergent use of CPB. Mean transpulmonary pressure gradient immediately after and 24 hours after the BDG were 6.7 and 5.6 mmHg, respectively. Echocardiography showed mild flow turbulence at the anastomosis in 1 case. This simple and inexpensive technique provided good surgical view with stable hemodynamics enabling satisfactory BDG in selected cases. Furthermore, it could avoid adverse effects of CPB such as lung injury and possible blood transfusion. This experience would encourage off-pump BDG combined with more challenging procedures.

Matched MeSH terms: Pulmonary Artery/surgery*

Fulltext Pulmonary artery aneurysm associated with severe degenerative aortic stenosis

Ling PK

Singapore Med J, 2009 Oct;50(10):e350-2.

PMID: 19907873

We report a pulmonary artery (PA) aneurysm associated with severe aortic stenosis and an aortic root dilatation occurring in a 59-year-old woman who presented with dyspnoea and chest pain. PA aneurysms are rare, and there are no definitive guidelines on its management. There are contentious opinions on whether such aneurysms should be managed conservatively or surgically. Our patient had associated aortic stenosis and underwent a successful aortic valve replacement and PA aneurysm repair. This case illustrates that concomitant PA repair with other cardiothoracic surgery can be performed safely, even in patients with moderate surgical risks. We also discuss the natural history, prognosis and management of PA aneurysms.

Matched MeSH terms: Pulmonary Artery/surgery

Aneurysmal dilatation without distal obstruction: a rare complication of valved bovine jugular vein conduit

Qureshi AU, Abbaker AE, Sivalingam S, Latiff HA

World J Pediatr Congenit Heart Surg, 2014 Apr;5(2):348-51.

PMID: 24668992 DOI: 10.1177/2150135113509819

Valved bovine jugular vein (Contegra) conduit is considered a suitable choice for pediatric population with congenital heart defect requiring right ventricle to main pulmonary artery connection. Intermediate follow-up studies have shown the propensity of developing distal conduit stenosis and valve thrombosis. We present a rare case of aneurysmal dilatation of the conduit leading to valve failure requiring conduit explantation.

Matched MeSH terms: Pulmonary Artery/surgery

Impact of ductal stenting on pulmonary artery reconstruction in patients with duct-dependent congenital heart diseases-an institutional experience

Haranal M, Mood MC, Leong MC, Febrianti Z, Abdul Latiff H, Samion H, et al.

Interact Cardiovasc Thorac Surg, 2020 08 01;31(2):221-227.

PMID: 32437520 DOI: 10.1093/icvts/ivaa069

OBJECTIVES: This study aims to review our institutional experience of ductal stenting (DS) on the growth of pulmonary arteries (PAs) and surgical outcomes of PA reconstruction in this subset of patients.

METHODS: This is a retrospective study done in neonates and infants up to 3 months of age with duct-dependent pulmonary circulation who underwent DS from January 2014 to December 2015. Post-stenting PA growth, surgical outcomes of PA reconstruction, post-surgical re-interventions, morbidity and mortality were analysed.

RESULTS: During the study period, 46 patients underwent successful DS, of whom 38 underwent presurgery catheterization and definite surgery. There was significant growth of PAs in these patients. Biventricular repair was done in 31 patients while 7 had univentricular palliation. Left PA augmentation was required in 13 patients, and 10 required central PA augmentation during surgery. The mean follow-up period post-surgery was 4.5 ± 1.5 years. No significant postoperative complications were seen. No early or follow-up post-surgery mortality was seen. Four patients required re-interventions in the form of left PA stenting based on the echocardiography or computed tomography evidence of significant stenosis.

CONCLUSIONS: DS provides good short-term palliation and the growth of PAs. However, a significant number of stented patients require reparative procedure on PAs at the time of surgical intervention. Acquired changes in the PAs following DS may be the reason for reintervention following PA reconstruction.

Matched MeSH terms: Pulmonary Artery/surgery*

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