The Cases of Total Correction for Corrected Transposition of the Great Arteries after the Reconstruction of the Left Pulmonary Artery Using Heterologous Pericardial Conduit.
10.4326/jjcvs.25.131
- VernacularTitle:Ｎｏｎ‐ｃｏｎｆｌｕｅｎｔな肺動脈を伴った修正大血管転位，心室中隔欠損，肺動脈閉鎖に対し異種心膜ロールを用いた左肺動脈再建術後に根治術を施行した２例
- Author:
Youichi Kawahira
;
Hidefumi Kishimoto
;
Masahiko Iio
;
Seiichiro Ikawa
;
Hideki Ueda
;
Toshiya Maeno
;
Futoshi Kayatani
;
Noboru Inamura
;
Takeshi Nakada
- Publication Type:Journal Article
- Keywords:
non-confluent PA
- From:Japanese Journal of Cardiovascular Surgery
1996;25(2):131-134
- CountryJapan
- Language:Japanese
-
Abstract:
We report two surgical cases with corrected transposition of the great arteries associated with ventricular septal defect and pulmonary atresia undergoing total correction including reconstruction of the central pulmonary artery after reconstruction of the left pulmonary artery for non-confluent pulmonary arteries. Both patients underwent reconstruction of the left pulmonary artery using 13 or 12mm diameter heterologous pericardial conduit at age of 5 year, respectively. At surgery, after the left pulmonary artery was exposed between the upper and lower lobe of the left lung, the conduit was connected with the left pulmonary artery along the pericardium. Continuity between the conduit and the left subclavian artery or the ascending aorta was established with 5 or 6mm diameter Micronit grafts, respectively. Total correction was performed at 2 years and 10 months after the initial surgery, respectively. In a patient with {I, D, D} type corrected transposition of the great arteries, the central pulmonary artery was established with another 16mm diameter heterologous pericardial conduit, which ran in front of the left superior vena cava. The ventricular septal defect was closed via the right atrium. In another patient with {S, L, L}, the central pulmonary artery was established with the reconstructed conduit of the left pulmonary artery, which ran behind the left phrenic nerve. The ventricular septal defect was closed via the right atrium with the De Leval procedure. In both patients, continuities between the left ventricle and the central pulmonary artery were established with tricuspid valved porcine pericardial conduit and equine pericardial conduit. Postoperatively both patients had uneventful recovery with left ventricular/right ventricular systolic pressure ratios of 0.4 and 0.35, respectively.
