Surgical Results in Patients With Pulmonary Atresia-Major Aortopulmonary Collaterals in Association With Total Anomalous Pulmonary Venous Connection

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Double inlet Left Ventricle Apical four chamber view showing double inlet left ventricle. Note the presence of two atrioventricular valves connecting to.

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Surgical Results in Patients With Pulmonary Atresia-Major Aortopulmonary Collaterals in Association With Total Anomalous Pulmonary Venous Connection Richard D. Mainwaring, MD, V. Mohan Reddy, MD, Olaf Reinhartz, MD, Rajesh Punn, MD, Theresa Tacy, MD, Frank L. Hanley, MD The Annals of Thoracic Surgery Volume 92, Issue 5, Pages 1756-1760 (November 2011) DOI: 10.1016/j.athoracsur.2011.06.020 Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Echocardiogram from a four-chamber view demonstrating the presence of a complete atrioventricular septal defect (AVSD) with hypoplasia of the right ventricle (RV). (AVV = atrioventricular valve; LA = left atrium; LV left ventricle; VSD = ventricular septal defect.) The Annals of Thoracic Surgery 2011 92, 1756-1760DOI: (10.1016/j.athoracsur.2011.06.020) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Echocardiogram of the left atrial (LA) anatomy in the same patient as shown in Figure 1. (A) The cor triatriatum membrane is demonstrated and labeled. (B) The color flow Doppler signal demonstrates acceleration across the cor triatriatum membrane. The Annals of Thoracic Surgery 2011 92, 1756-1760DOI: (10.1016/j.athoracsur.2011.06.020) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Patient flow diagram for all 9 patients in this series and the current stage of management demonstrated for the 6 surviving patients. (BDG = bidirectional Glenn procedure.) The Annals of Thoracic Surgery 2011 92, 1756-1760DOI: (10.1016/j.athoracsur.2011.06.020) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Pulmonary angiogram of the same patient as shown in Figures 1 and 2; this study was performed in preparation for the bidirectional Glenn procedure. The patient has undergone complete unifocalization, repair of total anomalous pulmonary venous connection, and repair of cor triatriatum. The angiogram demonstrates a reasonably normal pulmonary arterial arborization, and the hemodynamic measurements resulted in a calculated pulmonary vascular resistance of 1.2 Woods units. (LPA = left pulmonary artery; MPA = main pulmonary artery; RPA = right pulmonary artery.) The Annals of Thoracic Surgery 2011 92, 1756-1760DOI: (10.1016/j.athoracsur.2011.06.020) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions