Woo Sung Jang, MD, PhD, Woong-Han Kim, MD, PhD, Sungkyu Cho, MD

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Effects of Angle Correction Angioplasty for Pulmonary Artery Stenosis With Tetralogy of Fallot Woo Sung Jang, MD, PhD, Woong-Han Kim, MD, PhD, Sungkyu Cho, MD The Annals of Thoracic Surgery Volume 103, Issue 3, Pages 862-868 (March 2017) DOI: 10.1016/j.athoracsur.2016.08.002 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Schematic drawing of a left pulmonary artery (LPA) acute-angle correction angioplasty. (A–B) The main pulmonary artery (MPA) longitudinal incision and extension to the LPA inferior margin crossing the LPA ostium, (C–D) anterior wall flap of MPA unfolding toward the LPA and augmentation of the posterior wall of the distal LPA, and (E–F) MPA and LPA augmentation with a pericardial patch. The Annals of Thoracic Surgery 2017 103, 862-868DOI: (10.1016/j.athoracsur.2016.08.002) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Conventional patch angioplasty. (A–B) Longitudinal incision of main pulmonary artery and left pulmonary artery, and (C) patch angioplasty with pericardial patch. The Annals of Thoracic Surgery 2017 103, 862-868DOI: (10.1016/j.athoracsur.2016.08.002) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Preoperative left pulmonary artery (LPA) stenosis (arrow) and improvement in stenosis (arrow) after acute-angle correction preoperative LPA stenosis in (A) three-dimensional reconstruction computed tomography scan and (B) two-dimensional (2D) axial view. (C–D) Postoperative LPA improvement in 2D axial view. The Annals of Thoracic Surgery 2017 103, 862-868DOI: (10.1016/j.athoracsur.2016.08.002) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 The changes in left pulmonary artery (LPA) z score according to stenosis type between the two groups. (A) The changes in the LPA ostium (os) z score according to stenosis type, and (B) the changes in the LPA hilum z score according to stenosis type. In group I (acute angle, acute-angle correction angioplasty), the os z score in patients with type II stenosis was significantly lower than values in patients with type I stenosis (p = 0.069), and the z score improvement of LPA ostium uncovered by analysis of covariance was lower for patients with type II stenosis in group I than for patients with type II stenosis in group II (obtuse angle, conventional patch angioplasty) (p = 0.011). (Prehilum = preoperative hilum; Preos = preoperative ostium.) The Annals of Thoracic Surgery 2017 103, 862-868DOI: (10.1016/j.athoracsur.2016.08.002) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions