Right ventricular outflow tract reconstruction in two neonates with pulmonary atresia and intact ventricular septum
Kitano, M.; Yakota, M.; Kyoku, I.; Mizuhara, H.; Sakamoto, K.; Shimada, I.
Nihon Kyobu Geka Gakkai 38(7): 1209-1213
1990
ISSN/ISBN: 0369-4739 PMID: 2212785 Document Number: 351846
Two neonates, aged 8 and 18 days, with pulmonary atresia and intact ventricular septum underwent right ventricular outflow tract reconstruction with an autologous pericardial transannular patch. Preoperative cardiac catheterization revealed a tripartite right ventricular morphology with suprasystemic right ventricular morphology with suprasystemic right ventricular systolic pressure (right ventricular to left ventricular peak pressure ratio was 1.2 in case 1 and 2.0 in case 2). Right ventricular volume was 73.5% of normal and 115% of normal respectively. Generous resection of the infundibular myocardium was done and a patch was inserted with the heart kept beating as the perfusate temperature of 32.degree. C. In case 1 a modified Blalock-Taussig shunt was added on the postoperative day 21, because of the insufficient growth of the right ventricle, but in case 2 prostaglandin E1 could be discontinued on the postoperative day 9.