Surgical strategy for pulmonary coarctation in the univentricular heart

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Kim, Hyun Koo; Kim, Woong-Han; Kim, Soo-Cheol; Lim, Cheong; Lee, Chang Ha; Kim, Soo-Jin
Issue Date
Eur J Cardiothorac Surg. 2006 Jan;29(1):100-4. Epub 2005 Dec 5.
Anastomosis, Surgical/instrumentationAngioplasty/methodsArterial Occlusive Diseases/physiopathology/*surgeryCardiac Surgical Procedures/instrumentationEquipment DesignHeart Defects, Congenital/pathology/physiopathology/*surgeryHeart Ventricles/abnormalitiesHumansInfantInfant, NewbornPolytetrafluoroethylenePulmonary Artery/pathology/physiopathology/*surgeryPulmonary Circulation/physiologyReoperationRetrospective StudiesTreatment Outcome
OBJECTIVE: The placement of a modified Blalock-Taussig shunt in patients suffering from pulmonary coarctation can result in the aggravation of uneven pulmonary blood flow. This may subsequently obviate the possibility of future performance of the Fontan procedure. The objective of this study was to evaluate mid-term results in patients with pulmonary coarctation who had undergone the placement of a modified Blalock-Taussig shunt, coupled with a pulmonary artery angioplasty. METHODS: We retrospectively reviewed the records of 13 patients who had undergone the placement of a modified Blalock-Taussig shunt, coupled with concomitant pulmonary angioplasty, between September 1998 and August 2002. All patients received follow-up angiographic evaluations. RESULTS: On the ipsilateral side of the modified Blalock-Taussig shunt, we observed a significant increase in the pulmonary artery index during a mean follow-up period of 11+/-5 months (preoperative 82+/-37 mm2/m2, follow-up 129+/-57, p=0.03). On the contralateral side, we also observed a significant increase in the pulmonary artery index (preoperative 90+/-56 mm2/m2, follow-up 137+/-56, p=0.047). There was one late death. During the follow-up period (mean 23+/-18 months), 10 patients received either a bidirectional or total cavopulmonary shunt and five of these patients underwent extracardiac Fontan operations. CONCLUSIONS: Our study demonstrated that the placement of a modified Blalock-Taussig shunt, with concomitant pulmonary artery angioplasty, constitutes a good initial surgical strategy in cases of univentricular heart with pulmonary coarctation.
1010-7940 (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Thoracic Surgery (흉부외과학전공)Journal Papers (저널논문_흉부외과학전공)
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