scholarly journals Main pulmonary artery swing back for univentricular heart

2021 ◽  
Vol 8 (9) ◽  
pp. 2799
Author(s):  
Jecco Ani Babu ◽  
Swaminathan Vaidyanathan ◽  
Neville Solomon ◽  
Janeel Musthafa
Keyword(s):  
Pulmonary Artery ◽  
Structural Changes ◽  
Work Of Breathing ◽  
Main Pulmonary Artery ◽  
Insertion Site ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Univentricular Heart ◽  
Term Outcome ◽  
Long Term Outcome

Left pulmonary artery (LPA) surgical arterioplasty done for juxtaductal pulmonary artery coarctation is a challenging technique that has often produced unsatisfactory outcomes because of poor outcome later and incomplete understanding of the evolution of structural changes in these vessels. We report a unique technique for LPA plasty involving main pulmonary artery (MPA) swing back, in a toddler who presented with history of increased work of breathing, cyanosis and failure to thrive since birth, where the MPA was detached and was swung back cranially to be anastomosed to LPA. This technique can be done, especially in univentricular heart (future Fontan candidate), since MPA needs to be interrupted. The patient had heterotaxy syndrome, left atrial isomerism, hypoplastic pulmonary valve with severe sub-valvar stenosis, duct dependent pulmonary circulation, good sized confluent branch pulmonary arteries with LPA narrowing at ductal insertion site, interrupted IVC with hemiazygous continuation and left SVC draining into coronary sinus. Initially underwent right modified Blalock taussig (BT) shunt, atrial septectomy, LPA plasty and PDA ligation at 6 months of age. Upon follow up after a year, diagnostic angiogram confirmed good flow in BT shunt and LPA re-stenosis with malpositioned great arteries. Redo sternotomy and Kawashima procedure was performed. BT shunt and MPA stump were divided. To conclude, the detached MPA segment was swung cranially and anstomosed to LPA (end to end) inferiorly and left SVC-LPA anstomosed superiorly onto this by end to side fashion. The early outcome was satisfactory, however long-term outcome needs to be followed up

scholarly journals Pulmonary atresia with a ventricular septal defect and left pulmonary artery discontinuity: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hyun-Hwa Cha ◽  
Hae Min Kim ◽  
Won Joon Seong
Keyword(s):  
Pulmonary Artery ◽  
Subclavian Artery ◽  
Septal Defect ◽  
Left Subclavian Artery ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Pulmonary Atresia ◽  
Left Pulmonary Artery ◽  
Right Pulmonary Artery

Abstract Background Unilateral pulmonary artery discontinuity is a rare malformation that is associated with other intracardiac abnormalities. Cases accompanied by other cardiac abnormalities are often missed on prenatal echocardiography. The prenatal diagnosis of isolated unilateral pulmonary artery discontinuity can also be delayed. However, undiagnosed this malformation would have an effect on further prognosis. We report our case of a prenatal diagnosis of pulmonary atresia with ventricular septal defect and left pulmonary artery discontinuity. Case presentation A 33-year-old Asian woman visited our institution at 24 weeks of gestation because of suspected fetal congenital heart disease. Fetal echocardiography revealed a small atretic main pulmonary artery giving rise to the right pulmonary artery without bifurcation and the left pulmonary artery arising from the ductus arteriosus originating from the left subclavian artery. The neonate was delivered by cesarean section at 376/7 weeks of gestation. Postnatal echocardiography and multidetector computed tomography showed a right aortic arch, with the small right pulmonary artery originating from the atretic main pulmonary artery and the left pulmonary artery originating from the left subclavian artery. Patency of the ductus arteriosus from the left subclavian artery was maintained with prostaglandin E1. Right ventricular outflow tract reconstruction and pulmonary angioplasty with Gore-Tex graft patch was performed 25th day after birth. Unfortunately, the neonate died because of right heart failure 8 days postoperation. Conclusion There is a possibility that both pulmonary arteries do not arise from the same great artery (main pulmonary artery or common arterial trunk). Therefore, clinicians should check the origin of both pulmonary arteries.

Arterial Duct Closure with Detachable Coils: Application in the Small Child

2002 ◽  
Vol 10 (2) ◽  
pp. 124-128 ◽  
Author(s):  
Ümrah Aydoğan
Keyword(s):  
Pulmonary Artery ◽  
Flow Velocity ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Small Child ◽  
Coil Occlusion ◽  
Detachable Coils

Transcatheter closure of patent ductus arteriosus using controlled-release coils was performed in 16 patients weighing < 10 kg. No embolization occurred. Procedure-related complications occurred in 3 patients (18.8%): massive femoral hemorrhage in 1 and femoral artery thrombosis in 2. The ductus recanalized in 1 of them because of mechanical hemolysis caused by streptokinase treatment. This was the only patient who underwent another occlusion procedure. Complete occlusion was achieved in 7 patients (43.8%) immediately, in 13 (81.2%) the following day, and in all 15 patients who had completed the 6-month follow-up. During follow-up, flow velocities between the left and the main pulmonary arteries and between the descending and the ascending aortae did not differ significantly. Flow velocity was > 2 m·sec−1 in 3 patients in the left pulmonary artery and in 1 in the descending aorta. Protrusion of the coil was seen in 3 of these patients. Flow velocity was also high in the main pulmonary artery in the 4th patient. In conclusion, coil occlusion of ductus arteriosus is feasible in the small child, but no more than half a loop of the coil should be left at the pulmonary site. High flow velocity does not always mean obstruction.

scholarly journals A Case of Pulmonary Sarcoma with Significant Extension into the Right Lung

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Yoshiaki Inoue ◽  
Yotaro Izumi ◽  
Kenjiro Sakaki ◽  
Keiko Abe ◽  
Teruaki Oka ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Spindle Cell Carcinoma ◽  
Pulmonary Artery Sarcoma ◽  
Contrast Enhanced Ct ◽  
Lung Segment ◽  
Significant Extension ◽  
The Right

A female patient in her 30s was referred to us with a mass approximately 8 centimeters in diameter in right lung segment 6. Bronchoscopy was done, and a tumorous lesion obstructing right B6 was found. Biopsy of this lesion supported suspicions of sarcoma or spindle cell carcinoma. Contrast-enhanced CT showed that the mass extended to and obstructed the right main pulmonary artery. A skip lesion was also suspected in the periphery of pulmonary artery trunk. The tumor was removed by right pneumonectomy accompanied by resection of the main and left pulmonary arteries under cardiopulmonary bypass. The pulmonary artery trunk and the left pulmonary artery were reconstructed with a vascular graft. Collectively, intimal sarcoma originating from the right main pulmonary artery with extension into the right lung was diagnosed. Significant extension of pulmonary artery sarcoma into the lung, as was observed in the present case, is considered to be rare, and to our knowledge this is the first report in which the primary lesion was biopsied by bronchoscopy.

In-Vitro Pulsatile Flow Visualization Studies in a Pulmonary Artery Model

1985 ◽  
Vol 107 (4) ◽  
pp. 368-375 ◽  
Author(s):  
E. Philpot ◽  
A. P. Yoganathan ◽  
H.-W. Sung ◽  
Y.-R. Woo ◽  
R. H. Franch ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Flow Visualization ◽  
Pulsatile Flow ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Deceleration Phase ◽  
Right Pulmonary Artery ◽  
The Right

In-vitro pulsatile flow visualization studies were conducted in an adult-sized pulmonary artery model to observe the effects of valvular pulmonic stenosis on the flow fields of the main, left and right pulmonary arteries. The flow patterns revealed that as the degree of stenosis increased, the jet-type flow created by the valve became narrower, and it impinged on the far (distal) wall of the left pulmonary artery further downstream from the junction of the bifurcation. This in turn led to larger regions of disturbed turbulent flow, as well as helical-type secondary flow motions in the left pulmonary artery, compared to the right pulmonary artery. The flow field in the main pulmonary artery also became more disturbed and turbulent, especially during peak systole and the deceleration phase. The flow visualization observations have been valuable in helping to conduct further quantitative studies such as pressure and velocity field mapping. Such studies are important to understanding the fluid mechanics characteristics of the main pulmonary artery and its two major branches.

Outcome at 26 Years After Repair of Fallot’s Tetralogy With Absent Left Pulmonary Artery

2020 ◽  
Vol 11 (5) ◽  
pp. 661-663
Author(s):  
Guglielmo Stefanelli ◽  
Marco Meli ◽  
Rosaria Nardelli ◽  
Emilio Chiurlia ◽  
Luca Weltert
Keyword(s):  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Left Pulmonary Artery ◽  
Peripheral Oxygen Saturation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Lung Repair ◽  
Lung Scan ◽  
The Right

We report long-term outcome after two-stage, “one lung repair” in a four-year-old boy with tetralogy of Fallot and congenital absence of the left pulmonary artery. The operation was carried out two years after a palliative aortopulmonary central shunt and was uneventful. Twenty-six years later, the patient is in excellent clinical condition, with normal peripheral oxygen saturation. A recent radionuclide lung scan and cardiac magnetic resonance imaging show the pulmonary flow entirely directed into the right lung. In selected cases, the long-term prognosis of patients with tetralogy of Fallot and true absence of left pulmonary artery after “one lung repair” may be excellent.

scholarly journals Gastric wall fat falo sign as a risk factor for cardiovascular diseases

2020 ◽  
Author(s):  
Ali Kupeli ◽  
Ethem Unver ◽  
Gurkan Danisan ◽  
Eser Bulut
Keyword(s):  
Pulmonary Artery ◽  
Gastric Wall ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Ascending Aorta ◽  
Control Group ◽  
Descending Aorta ◽  
Cardiothoracic Ratio ◽  
Halo Sign

A B S T R A C T Objective: To investigate the relationship between gastric wall fat halo sign and potentially associated cardiovascular disease (CVD) in thoracic computed tomography (CT). Material and Methods: Between October 2018 and June 2019, 62 patients with gastric wall fat halo sign and 97 controls were prospectively evaluated. Patient height, weight, body mass index (BMI), sex, age, ascending aorta, descending aorta, main pulmonary artery, right and left pulmonary artery, long and short cardiac axis and maximum transverse thorax diameters; and ascending, arcus, descending aorta and coronary artery calcium scores were recorded for the two groups. Results: No significant differences were found in sex, age, height, body weight or BMI between the two groups (p > 0.125). Patients with gastric wall fat halo sign had significantly larger diameters of the ascending aorta, the descending aorta, the main pulmonary artery, the right and left pulmonary arteries, and the short and long cardiac axes and a higher cardiothoracic ratio (CTR) than the control group (p < 0.001). Additionally, the calcium scores of the ascending, arcus, and descending aortas and the coronary arteries were significantly higher detected in patients group (p < 0.001). Conclusion: The gastric wall fat halo is the result of excessive fat accumulation and can be observed in overweight people, especially those with increased visceral fat tissue. Additionally, patients with a gastric wall fat halo have a higher cardiovascular risk because of increased vascular diameters, CTR, heart sizes and calcium scores.

Univentricular Heart With Bridging Bronchus and Sling Left Pulmonary Artery

2012 ◽  
Vol 34 (5) ◽  
pp. 1280-1282 ◽  
Author(s):  
Nobuyuki Inoue ◽  
Norihiko Oka ◽  
Kagami Miyaji
Keyword(s):  
Pulmonary Artery ◽  
Left Pulmonary Artery ◽  
Univentricular Heart ◽  
Bridging Bronchus

Blood Flow Velocity Profiles in Pulmonary Branch Arteries in Lambs

1995 ◽  
Vol 117 (2) ◽  
pp. 237-241
Author(s):  
H. Katayama ◽  
G. W. Henry ◽  
C. L. Lucas ◽  
B. Ha ◽  
J. I. Ferreiro ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Maximum Velocity ◽  
Left Pulmonary Artery ◽  
Control Group ◽  
Pulsed Doppler Ultrasound ◽  
Right Pulmonary Artery ◽  
Blood Flow Velocities ◽  
The Right

We studied the detailed profiles of blood flow in the right and left pulmonary arteries using 20 MHz pulsed Doppler ultrasound equipment in a lamb model. Fourteen lambs aged four to six weeks were selected. In six lambs, monocrotaline pyrrole was injected parenterally to create pulmonary hypertension (PH group). Eight other lambs served as unaltered controls (control group). The blood flow velocities were sampled in 1mm increments along the anterior—posterior axis of the branch arteries. The maximum velocity of the forward flow in the left pulmonary artery was higher than that in the right pulmonary artery in the control group (71.7 ± 15.9cm/s vs 60.2 ± 13.5; p < 0.05). The fastest backward flow was located at the posterior position of the vessel in the right pulmonary artery in the control group. No significant bias in location was shown in the left pulmonary artery. Using indices of P90, acceleration time, P90*AcT, the velocity waveforms in the PH group were compared with those in the control group. In the left pulmonary artery, every index in the control group showed a significantly greater value that in the PH group. On the other hand, no significant differences were found between either group in the right pulmonary artery.

scholarly journals Rehabilitation of pulmonary arteries: hybrid treatment in the unilateral absence of the pulmonary artery.

2021 ◽  
Author(s):  
Jorge Cervantes-Salazar ◽  
Jose García-Montes ◽  
Henry Peralta-Santos ◽  
Diego Ortega-Zhindón ◽  
Juan Calderón-Colmenero
Keyword(s):  
Pulmonary Artery ◽  
Respiratory Infections ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Surgical Reconstruction ◽  
Hybrid Strategy ◽  
Right Pulmonary Artery ◽  
History Of ◽  
Bilateral Ductus Arteriosus

We present two patients with history of recurrent respiratory infections, fatigue and sweating. They were diagnosed with absence of connection between the main pulmonary artery (MPA) and right pulmonary artery (RPA) and bilateral ductus arteriosus, with the RPA originating from the ductus arteriosus. Treatment was approached with a hybrid strategy: percutaneous intraluminal angioplasty with a right intraductal stent and device closure of the left ductus arteriosus and followed by surgical reconstruction with interposition of a graft from RPA to MPA. Both patients had a favorable outcome.

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