Efficacy of the 'intrapulmonary-artery septation' surgical approach for Fontan candidates with unilateral pulmonary arterial hypoplasia†

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Maiko TachiKisaburo Sakamoto

Abstract

The bilaterally unbalanced development of pulmonary arteries (PAs), as a result of unilateral pulmonary arterial hypoplasia (PAhypo) makes patients either ineligible for the Fontan operation or candidates for the one-lung Fontan operation. In the present study, we examined the efficacy of intrapulmonary-artery septation (IPAS), a technique we reported in 2007 in which a septation is constructed within the central PA, in patients with unilateral PAhypo. Sixteen patients with unilateral PAhypo and an affected PA index of ≤60 mm(2)/m(2), including non-confluent PA (NCPA), underwent IPAS between January 2000 and March 2012; patients with pulmonary venous obstruction were excluded from this study. We compared the affected PA index values before and after IPAS and after the Fontan operation as well as the bilateral pulmonary blood flow ratio using pulmonary scintigraphy. The post-Fontan operation values of central venous pressure (CVP), pulmonary vascular resistance (PVR), ventricular end-diastolic pressure (VEDP), cardiac index (CI) and arterial oxygen saturation (SaO2) at the most recent cardiac catheterization, as well as the pre-IPAS and post-Fontan New York Heart Association (NYHA) classification levels were examined. One patien...Continue Reading

References

May 1, 1971·Thorax·F Fontan, E Baudet
Mar 1, 1993·The Annals of Thoracic Surgery·C J Knott-CraigG K Danielson
Sep 26, 1997·The Journal of Thoracic and Cardiovascular Surgery·T L GentlesG Wernovsky
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Feb 6, 2002·The Journal of Thoracic and Cardiovascular Surgery·Christof StammRichard A Jonas
Jul 31, 2004·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Marshall L JacobsWilliam I Norwood
Jan 24, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Riad B M HoseinWilliam J Brawn
Oct 24, 2007·The Annals of Thoracic Surgery·Toshihide NakanoYusuke Ando
Nov 22, 2008·The Annals of Thoracic Surgery·Emile A BachaDoff B McElhinney
Jul 10, 2012·The Annals of Thoracic Surgery·Yasuhiro FujiiKozo Matsuo
Aug 31, 2013·General Thoracic and Cardiovascular Surgery·Jun AmanoHiroyasu Yokomise

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Citations

Jun 8, 2018·Asian Cardiovascular & Thoracic Annals·Kota AgematsuYorikazu Harada
Feb 14, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Motonori IshidouKisaburo Sakamoto
Sep 26, 2020·Seminars in Thoracic and Cardiovascular Surgery·Cameron S SeamanMichael M H Cheung

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