| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1989;47:213-217
© 1989 The Society of Thoracic Surgeons
Division of Cardiovascular Surgery and Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada
* Address reprint requests to Dr Coles, The Hospital for Sick Children, 555 University Ave, Toronto, Ont, Canada M5G 1X8.
Out entire institutional experience with pulmonary atresia and intact ventricular septum (1965 through 1987) included 115 patients, 16 of whom died before surgical intervention. Fifty-six percent of surgical patients (n = 99) had angiographic evidence of right ventricle-coronary arterial connections. The early mortality in the surgical group was 27.2%, and the actuarial survival was 24.7% ± 6% at 13 years postoperatively. Multivariate analysis indicated that the presence of ventriculocoronary connections (p = 0.037), a decreasing ratio between right ventricular and left ventricular pressure at the initial cardiac catheterization (p = 0.007), and lower weight at operation (p = 0.001) were incremental risk factors for postoperative death; the presence of Ebstein's anomaly was an additional risk factor in the overall experience (including patients not surgically treated) (p = 0.01). Nearly all long-term survivors underwent at least one reoperation, including right ventricular outflow tract reconstruction (n = 39) and thromboexclusion of the right ventricle (n = 9). The presence of severe stenosis or interruption of the proximal left anterior descending coronary artery system was a uniformly lethal risk factor for patients undergoing these procedures (p = 0.0003). We conclude that surgical procedures that successfully decompress the right ventricle will usually result in biventricular circulation in and long-term survival of patients with pulmonary atresia with intact ventricular septum not complicated by Ebstein's anomaly or extensive ventriculocoronary connections. Decompression or thromboexclusion of the right ventricle is contraindicated in patients with ventriculocoronary connections and a right ventricle-dependent coronary circulation.
This article has been cited by other articles:
|
|
 |
|
  K. J. Guleserian, L. B. Armsby, R. R. Thiagarajan, P. J. del Nido, and J. E. Mayer Jr Natural History of Pulmonary Atresia With Intact Ventricular Septum and Right-Ventricle-Dependent Coronary Circulation Managed by the Single-Ventricle Approach Ann. Thorac. Surg., June 1, 2006; 81(6): 2250 - 2258. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Miyaji, A. Murakami, T.-i. Takasaki, K. Ohara, S. Takamoto, and H. Yoshimura Does a bidirectional Glenn shunt improve the oxygenation of right ventricle-dependent coronary circulation in pulmonary atresia with intact ventricular septum? J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1050 - 1053. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. E.F. Daubeney, D. Wang, D.J. Delany, B.R. Keeton, R.H. Anderson, Z. Slavik, M. Flather, S.A. Webber, and for the UK and Ireland Collaborative Study of Pulm Pulmonary atresia with intact ventricular septum: Predictors of early and medium-term outcome in a population-based study J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1071 - 1071. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y P Mi, A K T Chau, C S W Chiu, T C Yung, K S Lun, and Y F Cheung Evolution of the management approach for pulmonary atresia with intact ventricular septum Heart, May 1, 2005; 91(5): 657 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Yoshimura, M. Yamaguchi, H. Ohashi, Y. Oshima, S. Oka, M. Yoshida, H. Murakami, and T. Tei Pulmonary atresia with intact ventricular septum: Strategy based on right ventricular morphology J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1417 - 1426. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Humpl, B. Soderberg, B. W. McCrindle, D. G. Nykanen, R. M. Freedom, W. G. Williams, and L. N. Benson Percutaneous Balloon Valvotomy in Pulmonary Atresia With Intact Ventricular Septum: Impact on Patient Care Circulation, August 19, 2003; 108(7): 826 - 832. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. E. F. Daubeney, D. J. Delany, R. H. Anderson, G. G. S. Sandor, Z. Slavik, B. R. Keeton, S. A. Webber, and for the United Kingdom and Ireland Collaborative S Pulmonary atresia with intact ventricular septum: Range of morphology in a population-based study J. Am. Coll. Cardiol., May 15, 2002; 39(10): 1670 - 1679. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sano, K. Ishino, M. Kawada, E. Fujisawa, M. Kamada, and S.-i. Ohtsuki Staged biventricular repair of pulmonary atresia or stenosis with intact ventricular septum Ann. Thorac. Surg., November 1, 2000; 70(5): 1501 - 1506. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H Leonard, G Derrick, J O'Sullivan, and C Wren Natural and unnatural history of pulmonary atresia Heart, November 1, 2000; 84(5): 499 - 503. [Abstract] [Full Text]
|
|
|
|
|
|
F. Lacour-Gayet Congenital Heart Surgery Nomenclature and Database Project: right ventricular outflow tract obstruction-intact ventricular septum Ann. Thorac. Surg., April 1, 2000; 69(4): S83 - S96. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Alwi, K. Geetha, A. A. Bilkis, M. K. Lim, S. Hasri, A. L. Haifa, A. Sallehudin, and R. Zambahari Pulmonary atresia with intact ventricular septum percutaneous radiofrequency-assisted valvotomy and balloon dilation versus surgical valvotomy and blalock taussig shunt J. Am. Coll. Cardiol., February 1, 2000; 35(2): 468 - 476. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Jahangiri, D. Zurakowski, D. Bichell, J. E. Mayer, P. J. del Nido, and R. A. Jonas IMPROVED RESULTS WITH SELECTIVE MANAGEMENT IN PULMONARY ATRESIA WITH INTACT VENTRICULAR SEPTUM J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1046 - 1052. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y V Maeno, C Boutin, L K Hornberger, B W McCrindle, T Cavalle-Garrido, G Gladman, and J F Smallhorn Prenatal diagnosis of right ventricular outflow tract obstruction with intact ventricular septum, and detection of ventriculocoronary connections Heart, June 1, 1999; 81(6): 661 - 668. [Abstract] [Full Text]
|
|
|
|
|
|
C. Ovaert, S. A. Qureshi, E. Rosenthal, E. J. Baker, and M. Tynan Growth of the right ventricle after successful transcatheterpulmonary valvotomy in neonates and infants with pulmonary atresia and intactventricular septum J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1055 - 1059. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. K. Najm, W. G. Williams, J. G. Coles, I. M. Rebeyka, and R. M. Freedom Pulmonary Atresia With Intact Ventricular Septum: Results of the Fontan Procedure Ann. Thorac. Surg., March 1, 1997; 63(3): 669 - 675. [Abstract] [Full Text]
|
|
|
|
|
|
J. D. Waldman, R. B. Karp, J. J. Lamberti, M. E. Sand, D. G. Ruschhaupt, and B. Agarwala Tricuspid valve closure in pulmonary atresia and important RV-to-coronary artery connections Ann. Thorac. Surg., April 1, 1995; 59(4): 933 - 941. [Abstract] [PDF]
|
|
|
|
|
|
H. Laks, R. N. Gates, P. W. Grant, S. Drant, V. Allada, and B. Harake Aortic to right ventricular shunt for pulmonary atresia and intact ventricular septum Ann. Thorac. Surg., February 1, 1995; 59(2): 342 - 347. [Abstract] [PDF]
|
|
|
|
|
|
C. Bull, M. Kostelka, K. Sorensen, and M. de Leval Outcome measures for the neonatal management of pulmonary atresia with intact ventricular septum J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 359 - 366. [Abstract] [Full Text]
|
|
|
|
|
|
J. M. Pearl, H. Laks, D. G. Stein, D. C. Drinkwater, B. L. George, and R. G. Williams Total cavopulmonary anastomosis versus conventional modified Fontan procedure Ann. Thorac. Surg., August 1, 1991; 52(2): 189 - 196. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
