Skip to main content
Erschienen in: General Thoracic and Cardiovascular Surgery 6/2022

18.11.2021 | Original Article

Primary pulmonary artery reconstruction for functional single ventricle with absent central pulmonary artery and bilateral patent ductus arteriosus

verfasst von: Makoto Nakamura, Kazuyoshi Kanno, Masahiko Nishioka

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 6/2022

Einloggen, um Zugang zu erhalten

Abstract

Objective

This study aimed to evaluate and discuss the outcomes of creating a single systemic-pulmonary shunt and reconstruction of the pulmonary artery continuity in patients with a single functional ventricle, absent central pulmonary artery, and bilateral patent ductus arteriosus.

Methods

Six infants diagnosed with a functional single ventricle, absent central pulmonary artery, and bilateral patent ductus arteriosus were treated by creating a single systemic-pulmonary shunt and reconstructing the pulmonary artery continuity (primary operation) between January 2010 and September 2020. Pulmonary artery continuity was ensured using the remnant pulmonary artery and an autologous pericardial patch in five patients and a rolled autologous pericardium in one patient.

Results

All patients eventually underwent total cavopulmonary connection. Two patients underwent intrapulmonary artery septation before Glenn or total cavopulmonary connection procedure. The median follow-up period was 9.02 years (interquartile range, 3.90–9.53). No late deaths were observed.

Conclusions

Our strategy of establishing a single systemic-pulmonary shunt with reconstruction of the pulmonary artery continuity was useful for treating patients with a functional single ventricle with absent central pulmonary artery and bilateral patent ductus arteriosus. This procedure helped accomplish pulmonary artery growth and ensured an appropriate volume load after total cavopulmonary connection.
Literatur
1.
Zurück zum Zitat Nakata S, Imai Y, Takanashi Y, Kurosawa H, Tezuka K, Nakazawa M, et al. A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow. J Thorac Cardiovasc Surg. 1984;88:610–9.CrossRef Nakata S, Imai Y, Takanashi Y, Kurosawa H, Tezuka K, Nakazawa M, et al. A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow. J Thorac Cardiovasc Surg. 1984;88:610–9.CrossRef
2.
Zurück zum Zitat Sakamoto K, Ikai A, Fujimoto Y, Ota N. Novel surgical approach ‘intrapulmonary-artery septation’ for Fontan candidates with unilateral pulmonary arterial hypoplasia or pulmonary venous obstruction. Interact Cardiovasc Thorac Surg. 2007;6:150–4.CrossRef Sakamoto K, Ikai A, Fujimoto Y, Ota N. Novel surgical approach ‘intrapulmonary-artery septation’ for Fontan candidates with unilateral pulmonary arterial hypoplasia or pulmonary venous obstruction. Interact Cardiovasc Thorac Surg. 2007;6:150–4.CrossRef
3.
Zurück zum Zitat Tachi M, Murata M, Ide Y, Ito H, Kanno K, Imai K, et al. Efficacy of the ‘intrapulmonary-artery septation’ surgical approach for Fontan candidates with unilateral pulmonary arterial hypoplasia. Eur J Cardiothorac Surg. 2016;49:183–7.CrossRef Tachi M, Murata M, Ide Y, Ito H, Kanno K, Imai K, et al. Efficacy of the ‘intrapulmonary-artery septation’ surgical approach for Fontan candidates with unilateral pulmonary arterial hypoplasia. Eur J Cardiothorac Surg. 2016;49:183–7.CrossRef
4.
Zurück zum Zitat Shanley CJ, Lupinetti FM, Shah NL, Beekman RH III, Crowley DC, Bove EL. Primary unifocalization for the absence of intrapericardial pulmonary arteries in the neonate. J Thorac Cardiovasc Surg. 1993;106:237–47.CrossRef Shanley CJ, Lupinetti FM, Shah NL, Beekman RH III, Crowley DC, Bove EL. Primary unifocalization for the absence of intrapericardial pulmonary arteries in the neonate. J Thorac Cardiovasc Surg. 1993;106:237–47.CrossRef
5.
Zurück zum Zitat Murphy DN, Winlaw DS, Cooper SG, Nunn GR. Successful early surgical recruitment of the congenitally disconnected pulmonary artery. Ann Thorac Surg. 2004;77:29–35.CrossRef Murphy DN, Winlaw DS, Cooper SG, Nunn GR. Successful early surgical recruitment of the congenitally disconnected pulmonary artery. Ann Thorac Surg. 2004;77:29–35.CrossRef
6.
Zurück zum Zitat Sakamoto K, Ota N, Fujimoto Y, Murata M, Ide Y, Tachi M, et al. Primary central pulmonary artery plasty for single ventricle with ductal-associated pulmonary artery coarctation. Ann Thorac Surg. 2014;98:919–26.CrossRef Sakamoto K, Ota N, Fujimoto Y, Murata M, Ide Y, Tachi M, et al. Primary central pulmonary artery plasty for single ventricle with ductal-associated pulmonary artery coarctation. Ann Thorac Surg. 2014;98:919–26.CrossRef
7.
Zurück zum Zitat Yoneyama F, Okamura T, Harada Y. Extensibility of autologous pericardium roll conduit in non-confluent pulmonary artery: a case report. J Cardiothorac Surg. 2019;14:99.CrossRef Yoneyama F, Okamura T, Harada Y. Extensibility of autologous pericardium roll conduit in non-confluent pulmonary artery: a case report. J Cardiothorac Surg. 2019;14:99.CrossRef
8.
Zurück zum Zitat Kim GB, Ban JE, Bae EJ, Noh CI, Kim WH, Lee JR, et al. Rehabilitation of pulmonary artery in congenital unilateral absence of intrapericardial pulmonary artery. J Thorac Cardiovasc Surg. 2011;141:171–8.CrossRef Kim GB, Ban JE, Bae EJ, Noh CI, Kim WH, Lee JR, et al. Rehabilitation of pulmonary artery in congenital unilateral absence of intrapericardial pulmonary artery. J Thorac Cardiovasc Surg. 2011;141:171–8.CrossRef
9.
Zurück zum Zitat Fenton KN, Siewers RD, Rebovich B, Pigula FA. Interim mortality in infants with systemic-to-pulmonary artery shunts. Ann Thorac Surg. 2003;76:152–6 (Discussion 6-7).CrossRef Fenton KN, Siewers RD, Rebovich B, Pigula FA. Interim mortality in infants with systemic-to-pulmonary artery shunts. Ann Thorac Surg. 2003;76:152–6 (Discussion 6-7).CrossRef
10.
Zurück zum Zitat Myers JW, Ghanayem NS, Cao Y, Simpson P, Trapp K, Mitchell ME, et al. Outcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: analysis of shunt type, size, and surgical approach. J Thorac Cardiovasc Surg. 2014;147:672–7.CrossRef Myers JW, Ghanayem NS, Cao Y, Simpson P, Trapp K, Mitchell ME, et al. Outcomes of systemic to pulmonary artery shunts in patients weighing less than 3 kg: analysis of shunt type, size, and surgical approach. J Thorac Cardiovasc Surg. 2014;147:672–7.CrossRef
11.
Zurück zum Zitat Petrucci O, O’Brien SM, Jacobs ML, Jacobs JP, Manning PB, Eghtesady P. Risk factors for mortality and morbidity after the neonatal Blalock-Taussig shunt procedure. Ann Thorac Surg. 2011;92:642–51 (Discussion 651-2).CrossRef Petrucci O, O’Brien SM, Jacobs ML, Jacobs JP, Manning PB, Eghtesady P. Risk factors for mortality and morbidity after the neonatal Blalock-Taussig shunt procedure. Ann Thorac Surg. 2011;92:642–51 (Discussion 651-2).CrossRef
12.
Zurück zum Zitat Alkhulaifi AM, Lacour-Gayet F, Serraf A, Belli E, Planché C. Systemic pulmonary shunts in neonates: early clinical outcome and choice of surgical approach. Ann Thorac Surg. 2000;69:1499–504.CrossRef Alkhulaifi AM, Lacour-Gayet F, Serraf A, Belli E, Planché C. Systemic pulmonary shunts in neonates: early clinical outcome and choice of surgical approach. Ann Thorac Surg. 2000;69:1499–504.CrossRef
13.
Zurück zum Zitat Scott MB. Optimal timing for stage II: waiting for Godot. J Thorac Cardiovasc Surg. 2017;154:226–7.CrossRef Scott MB. Optimal timing for stage II: waiting for Godot. J Thorac Cardiovasc Surg. 2017;154:226–7.CrossRef
14.
Zurück zum Zitat Meza JM, Hickey E, McCrindle B, Blackstone E, Anderson B, Overman D, et al. The optimal timing of stage-2-palliation after the Norwood operation. Ann Thorac Surg. 2018;105:193–9.CrossRef Meza JM, Hickey E, McCrindle B, Blackstone E, Anderson B, Overman D, et al. The optimal timing of stage-2-palliation after the Norwood operation. Ann Thorac Surg. 2018;105:193–9.CrossRef
15.
Zurück zum Zitat Nakano T, Kado H, Tatewaki H, Hinokiyama K, Oda S, Ushinohama H, et al. Results of extracardiac conduit total cavopulmonary connection in 500 patients. Eur J Cardiothorac Surg. 2015;48:825–32 (Discussion 832).CrossRef Nakano T, Kado H, Tatewaki H, Hinokiyama K, Oda S, Ushinohama H, et al. Results of extracardiac conduit total cavopulmonary connection in 500 patients. Eur J Cardiothorac Surg. 2015;48:825–32 (Discussion 832).CrossRef
16.
Zurück zum Zitat Ono M, Kasnar-Samprec J, Hager A, Cleuziou J, Burri M, Langenbach C, et al. Clinical outcome following total cavopulmonary connection: a 20-year single-centre experience. Eur J Cardiothorac Surg. 2016;50:632–41.CrossRef Ono M, Kasnar-Samprec J, Hager A, Cleuziou J, Burri M, Langenbach C, et al. Clinical outcome following total cavopulmonary connection: a 20-year single-centre experience. Eur J Cardiothorac Surg. 2016;50:632–41.CrossRef
Metadaten
Titel
Primary pulmonary artery reconstruction for functional single ventricle with absent central pulmonary artery and bilateral patent ductus arteriosus
verfasst von
Makoto Nakamura
Kazuyoshi Kanno
Masahiko Nishioka
Publikationsdatum
18.11.2021
Verlag
Springer Nature Singapore
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 6/2022
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-021-01734-x

Weitere Artikel der Ausgabe 6/2022

General Thoracic and Cardiovascular Surgery 6/2022 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.