Definitive repair in patients with pulmonary atresia and intact ventricular septum

A. M. Billingsley, H. Laks, S. W. Boyce, B. George, T. Santulli, R. G. Williams, A. Chaux, B. J. Harlan, H. V. Schaff, P. A. Penkoske

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74 Scopus citations

Abstract

Between 1977 and 1988, 22 patients underwent definitive repair for pulmonary atresia with intact ventricular septum. Fifteen underwent biventricular repair (mean age 24 months). All had mild to moderate right ventricular hypoplasia at the time of definitive repair. Repair consisted of closure of the atrial septal defect with enlargement of the right ventricular cavity and outflow tract with a patch in eight, insertion of a valved homograft in three, and superior vena cava-pulmonary artery connection in four. There was one operative death (7%). Seven patients had severe right ventricular hypoplasia at the time of definitive repair and underwent a Fontan procedure (mean age 46 months). In two a valved connection was made to the right ventricle and in five a right atrial-pulmonary nonvalved connection. There were two operative deaths (29%). Three patients had right ventricular-coronary sinusoids: Two of them underwent a Fontan procedure and one a biventricular repair. We conclude that with adequate early palliation a biventricular repair may be successfully performed for patients with mild or moderate right ventricular hypoplasia, and the Fontan procedure may be used for those with severe right ventricular hypoplasia.

Original languageEnglish (US)
Pages (from-to)746-754
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume97
Issue number5
DOIs
StatePublished - 1989

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Billingsley, A. M., Laks, H., Boyce, S. W., George, B., Santulli, T., Williams, R. G., Chaux, A., Harlan, B. J., Schaff, H. V., & Penkoske, P. A. (1989). Definitive repair in patients with pulmonary atresia and intact ventricular septum. Journal of Thoracic and Cardiovascular Surgery, 97(5), 746-754. https://doi.org/10.1016/s0022-5223(19)34520-9