Classification of pulmonary arterial supply in pulmonary atresia with ventricular septal defect and treatment strategies
Ye Zankai
Fan Xiangming
Li Zhiqiang
Yang Xueyong
Liu Yinglong
Abstract：Objective To investigate the classifications of pulmonary arterial supply in pulmonary atresia with ventricular septal defect and treatment strategies.Methods From April 2012 to October 2013,a total of 48 patients with pulmonary atresia with ventricular septal defect were enrolled.All the patients were scanned with multidetector-row computed tomography(MDCT) and transthoracic echocardiography(TTE).All patients were evaluated in terms of the origins and the traces of major systemic-pulmonary collateral arteries (MAPCAs) as well as the McGoon ratio and Nakata Index.Results In the 48 cases,the pulmonary arterial supply was from the arterial duct(PDA) in 16 cases(33.3％),MAPCAs in 14 cases (29.1％),PDA coexist with MAPCAs in 18 cases (37.5％) ; the McGoon ratio was (1.21 ± 0.41) and the Nakata index was (130 ± 88) mm2/m2 ; During the perioperative stage,only two patients were dead.Procedures included unifocalization in 2 cases,Modified Blalock-Taussing shunt in 29 cases and bidirectional cavopulmonary anastomosis in 13 cases.Modified Blalock-Taussing shunt with bidirectional cavopulmonary anastomosis occurred in 4 cases.Conclusions Variations are found in the site of pulmonary atresia and the morphology of the pulmonary arterial supply in congenital anomaly of pulmonary atresia with ventricular septal defect.Generally,combined with MDCT and TTE,surgeons can obtain full-scale information of the specific cardiovascular abnormality and make surgical decisions to manage pulmonary atresia with ventricular septal defect.
Keywords：Pulmonary atresiaVentricualr septal defectPulmonary arterial supply
Publication Date：2014-05-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 636-640 )