Covered Stent Implantation into the Right Ventricular Outflow Tract in Infants with TOF/PA + VSD and Diminutive Pulmonary Arteries

2021 ◽  
Author(s):  
K. Gendera ◽  
R. Surmacz ◽  
E. Beran ◽  
D. Tanase ◽  
S. Georgiev ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Stent Implantation ◽  
Pulmonary Arteries ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Covered Stent ◽  
Outflow Tract ◽  
The Right

Single-stage correction, with extensive pulmonary arterial reconstruction, of a pulmonary arterial sling associated with tetralogy of Fallot

2009 ◽  
Vol 19 (5) ◽  
pp. 519-521 ◽  
Author(s):  
Onur S. Goksel ◽  
Emin Tireli ◽  
Ahmet Çelebi
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Pulmonary Arteries ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Single Stage ◽  
Arterial Reconstruction ◽  
Pulmonary Arterial ◽  
The Right

AbstractPulmonary arterial sling, rare in itself, is even rarer when associated with tetralogy of Fallot. Successful single-stage correction of this combination, with extensive pulmonary arterial reconstruction, has been reported only occasionally. We describe our experience with an 18 month-old girl, showing that extensive reconstruction of both the pulmonary arteries and the right ventricular outflow tract can permit single-stage correction in selected patients, resulting in favourable physiology and anatomy.

scholarly journals Mid-term outcomes of Contegra implantation for the reconstruction of the right ventricular outflow tract to proximal branch pulmonary arteries: Japan multicentre study

2021 ◽  
Author(s):  
Takaya Hoashi ◽  
Hajime Ichikawa ◽  
Keiichi Hirose ◽  
Naohiro Horio ◽  
Takahisa Sakurai ◽  
...  
Keyword(s):  
Risk Factor ◽  
Right Ventricular ◽  
Survival Rates ◽  
Pulmonary Arteries ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Free Survival ◽  
The Right

Abstract OBJECTIVES To reveal the mid-term outcomes of Contegra implantation for the reconstruction of the right ventricular outflow tract to proximal branch pulmonary arteries in a multicentre study. METHODS Between April 2013 and December 2019, 178 Contegra conduits were implanted at 5 Japanese institutes. The median age and body weight at operation were 16 months (25th–75th percentile: 8–32) and 8.3 kg (6.4–10.6). Sixteen patients were neonates (9.0%). Selected conduit sizes were 12 mm in 28 patients (15.7%), 14 mm in 67 patients (37.6%), 16 mm in 66 patients (37.1%), 18 mm in 5 patients (2.8%) and <12 mm in 12 patients (6.7%). Fifty-six grafts (31.4%) were ring supported. Proximal branch pulmonary arteries were concomitantly augmented in 85 patients (47.5%). Follow-up was completed in all patients and the median follow-up period was 3.1 years (1.3–5.1). RESULTS The overall, conduit explantation-free and conduit infection-free survival rates at 5 years were 91.3%, 71.0% and 83.7%, respectively. Infection (P = 0.009) and common arterial trunk (P = 0.024) were risk factors for explantation. Conduit durability was shorter in smaller one (P < 0.001). Catheter interventions (for conduit to proximal branch pulmonary artery)-free survival rates at 5 years was 52.9%; however, need for catheter interventions was not a risk factor for conduit explantation. CONCLUSIONS Mid-term outcomes of reconstruction of the right ventricular outflow tract to the proximal branch pulmonary arteries with Contegra were acceptable. The need for explantation over time was higher in smaller conduits. Conduit infection was a strong risk factor for conduit explantation. Frequently and repeated catheter interventions effectively extended the conduit durability.

Repair of tetralogy of Fallot with pulmonary atresia in early infancy

1995 ◽  
Vol 5 (4) ◽  
pp. 326-330 ◽  
Author(s):  
Hideki Uemura ◽  
Toshikatsu Yagihara ◽  
Yasunaru Kawashima
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Primary Repair ◽  
Pulmonary Arteries ◽  
Pulmonary Atresia ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Early Infancy ◽  
The Right

AbstractBelieving early repair to offer major benefits, we have repaired tetralogy of Fallot with pulmonary atresia in five infants aged less than six months. The ventricular septal defect was closed via a right atriotomy. The right ventriculotomy was 30±3% of the right ventricular length. The posterior wall of the right ventricular outflow tract was created by anastomosing directly the pulmonary trunk to the right ventriculotomy, or either by interposition of the left atrial appendage or an autologous pericardia! flap. The pathway was then roofed over with an equine pericardia! patch. All patients survived and are now doing well from 18 to 41 (31±11) months after the repair, although one patient required reoperation for relief of stenosis at the site of an anastomosis between the pulmonary arteries and the interposed left appendage. In the other patients, postoperative sequential echocardiography has shown no obstruction in the right ventricular outflow tract, nor significant pulmonary or tricuspid regurgitation. We conclude that primary repair in early infancy is an excellent option for surgical treatment of tetralogy of Fallot with pulmonary atresia.

Problems with the right ventricular outflow tract: a review of morphologic features and current therapeutic options

2004 ◽  
Vol 14 (5) ◽  
pp. 533-549 ◽  
Author(s):  
Luca A. Vricella ◽  
Mazyar Kanani ◽  
Andrew C. Cook ◽  
Duke E. Cameron ◽  
Victor T. Tsang
Keyword(s):  
Right Ventricular ◽  
Pulmonary Arteries ◽  
Pulmonary Regurgitation ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Therapeutic Options ◽  
Late Intervention ◽  
Initial Correction ◽  
The Right

Repair of complex malformations that necessitate restoration of continuity between the right ventricle and the pulmonary arteries can now safely be performed with low morbidity and mortality. Major concerns still remain on the long-term outlook for these patients, and about the durability of the different prostheses used to restore that continuity, whether during initial correction or at the time of reintervention for failure of the conduit or pulmonary regurgitation. In this review, we discuss the salient morphologic features of the right ventricular outflow tract, and then focus on the indications for early and late intervention, current therapeutic options, and outcomes.

Transcatheter stenting of the right ventricular outflow tract augments pulmonary arterial growth in symptomatic infants with right ventricular outflow tract obstruction and hypercyanotic spells

2016 ◽  
Vol 26 (7) ◽  
pp. 1260-1265 ◽  
Author(s):  
Eimear McGovern ◽  
Conall T. Morgan ◽  
Paul Oslizlok ◽  
Damien Kenny ◽  
Kevin P. Walsh ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Arteries ◽  
Right Ventricular Outflow Tract ◽  
Left Pulmonary Artery ◽  
Ventricular Outflow Tract ◽  
Pulmonary Haemorrhage ◽  
Outflow Tract ◽  
Ventricular Outflow Tract Obstruction ◽  
The Right

AbstractWe retrospectively reviewed all the children with right ventricular outflow tract obstruction, hypoplastic pulmonary annulus, and pulmonary arteries who underwent stenting of the right ventricular outflow tract for hypercyanotic spells at our institution between January, 2008 and December, 2013; nine patients who underwent cardiac catheterisation at a median age of 39 days (range 12–60 days) and weight of 3.6 kg (range 2.6–4.3 kg) were identified. The median number of stents placed was one stent (range 1–4). The median oxygen saturation increased from 60% to 96%. The median right pulmonary artery size increased from 3.3 to 5.5 mm (−2.68 to −0.92 Z-score), and the median left pulmonary artery size increased from 3.4 to 5.5 mm (−1.93 to 0 Z-scores). Among all, one patient developed transient pulmonary haemorrhage, and one patient had pericardial tamponade requiring drainage. Complete repair of tetralogy of Fallot +/− atrioventricular septal defect or double-outlet right ventricle was achieved in all nine patients. Transcatheter stent alleviation of the right ventricular outflow tract obstruction resolves hypercyanotic spells and allows reasonable growth of the pulmonary arteries to facilitate successful surgical repair. This represents a viable alternative to placement of a systemic-to-pulmonary artery shunt, particularly in small neonates.

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