Surgical treatment of pseudotruncus arteriosus
Kawata, H.; Naito, Y.; Koh, Y.; Yagihara, T.; Isobe, F.; Yamamoto, F.; Fujita, T.; Manabe, H.
Nihon Kyobu Geka Gakkai 35(2): 192-199
1987
ISSN/ISBN: 0369-4739 PMID: 2438362 Document Number: 286520
From December 1977 to May 1984, 48 patients of pseudotruncus arteriosus were undertaken surgery. Among them, the palliative operations were done for 34 and the radical operation for 14 patients, in which the palliative operation had been undergone for 8 patients. The first choice of palliative operation was Blalock-Taussig shunt. After the shunt operation, we performed central shunt operation or the reconstruction of right ventricular outflow tract, when the pulmonary artery did not develop enough for the radical operation. We actively performed bilateral systemic pulmonary shunt for the patient who had nonconfluent right and left pulmonary arteries, we did the radical operation for one of such patients. The reconstructive method for the pulmonary artery as the radical operation was xenograft valved conduit (2 patients) or patch enlargement of right ventricular outflow tract (2 patients). But, when LAPC was utilized for the radical operation, we had experienced severe pulmonary hypertension postoperatively. Therefore, we considered that the radical operation using the original pulmonary artery should be performed. In principle, we perform the systemic pulmonary shunt and treat LAPC before the radical operation. Only a few patients who underwent the palliative operation in the infancy were accompanied with LAPC. Our report suggested that the palliative operation at the infancy was advisable in order to bring the fair development of the pulmonary artery and to prevent the progress of LACP. There were a few patients with LACP, whose PA pressure were still high even after the radical operation in spite of the slight obstructive change of the pulmonary artery. Whether it is advisable to apply the radical operation to such a patient need further consideration.