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Primary repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: a useful approach  Raul F Abella, MD, Teresa.

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Presentation on theme: "Primary repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: a useful approach  Raul F Abella, MD, Teresa."— Presentation transcript:

1 Primary repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: a useful approach  Raul F Abella, MD, Teresa De la Torre, MD, Gerardo Mastropietro, CCP, Nuccia Morici, MD, Adriano Cipriani, MD, Carlo Marcelletti, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 127, Issue 1, Pages (January 2004) DOI: /S (03)

2 Figure 1 Preoperative descending aortoangiogram demonstrating systemic collaterals in case 4 (a patient with pulmonary atresia, ventricular septal defect, and small central pulmonary arteries). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

3 Figure 2 A, Descending thoracic aortic reconstruction. Ao*, Descending aortic segment plus collaterals; A, PTFE conduit. B, Operative photograph of descending thoracic aortic reconstruction. A, PTFE conduit; B, PTFE conduit that connects aortic segment to the native pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

4 Figure 3 Diagram (A) and operative photograph (B) of connection of the descending thoracic aortic segment containing the origin of all MAPCAs to the native pulmonary artery using an interposition PTFE conduit. B, PTFE conduit; Ao*, descending aortic segment plus collaterals. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

5 Figure 4 Diagram (A) and operative photograph (B) of connection of the right ventricle to the unifocalized pulmonary arteries using a valved conduit, creating the neo-pulmonary confluence. VC, Valved conduit; B, PTFE conduit connection of aortic segment to the native pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

6 Figure 5 Postoperative angiogram for primary unifocalization procedure in case 4. Angiographic evidence of unifocalized pulmonary arterial tree. C, valved conduit. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

7 Figure 6 Postoperative right ventricular angiogram after unifocalization procedure. C, pulmonary confluent; white asterisks, valved conduit; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

8 Figure 7 Postoperative angiogram demonstrating descending thoracic aortic reconstruction after unifocalization procedure. Ao, Aorta; LV, left ventricle; asterisk, descending thoracic aorta. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

9 Figure 8 Postoperative Tc99m lung perfusion scans demonstrate perfusion of both lungs in patient 2. DX, Right; OPD, oblique posterior right; SN, left; OPS, oblique posterior left. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

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