scholarly journals Infective endocarditis of main pulmonary artery in tetralogy of Fallot: "Transesophageal echocardiography adds lease of life"

2016 ◽  
Vol 19 (3) ◽  
pp. 551
Author(s):  
Arin Choudhury ◽  
Jitin Narula ◽  
PawanKumar Jain ◽  
PoonamMalhotra Kapoor
Keyword(s):  
Infective Endocarditis ◽  
Pulmonary Artery ◽  
Transesophageal Echocardiography ◽  
Tetralogy Of Fallot ◽  
Main Pulmonary Artery

scholarly journals Pulmonary Artery Perforation: Rare reported Complication of Pericardiectomy for Chronic Constrictive Pericarditis recorded on Transesophageal Echocardiography

2016 ◽  
Vol 4 (1) ◽  
pp. 17-18
Author(s):  
Sameer Taneja ◽  
Jitin Narula ◽  
Neeti Makhija ◽  
Milind P Hote
Keyword(s):  
Pulmonary Artery ◽  
Transesophageal Echocardiography ◽  
Constrictive Pericarditis ◽  
Main Pulmonary Artery ◽  
Iatrogenic Injury ◽  
Surgical Team ◽  
Vessel Injury ◽  
Major Vessel ◽  
Pulmonary Artery Perforation

ABSTRACT Major vessel injury is a possible complication during pericardiectomy for chronic constrictive pericarditis (CCP). We present a case of CCP, who while undergoing radical pericardiectomy incurred an iatrogenic injury of a major vessel with profuse bleeding. A rent in main pulmonary artery (MPA) was detected by the surgical team and simultaneously confirmed on transesophageal echocardiography (TEE), and a timely intervention was done. Importance of monitoring TEE in a patient undergoing pericardiectomy for CCP is highlighted. How to cite this article Makhija N, Narula J, Kumar S, Taneja S, Hote MP. Pulmonary Artery Perforation: Rare reported Complication of Pericardiectomy for Chronic Constrictive Pericarditis recorded on Transesophageal Echocardiography. J Perioper Echocardiogr 2016;4(1):17-18.

Intermediate Outcomes of Staged Tetralogy of Fallot Repair

2019 ◽  
Vol 10 (6) ◽  
pp. 694-701 ◽  
Author(s):  
Poonam Mahajan ◽  
Eric S. Ebenroth ◽  
Kirsten Borsheim ◽  
Sabena Husain ◽  
Na Bo ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Pulmonary Valve ◽  
Surgical Intervention ◽  
Main Pulmonary Artery ◽  
Postoperative Arrhythmia ◽  
Young Infants ◽  
Intermediate Outcomes ◽  
Valve Annulus ◽  
Early Surgical Intervention

Background: The optimal surgical strategy for tetralogy of Fallot (TOF) repair in neonates and young infants requiring early surgical intervention remains controversial. Our surgical center follows the uniform strategy of a staged approach with initial systemic-to-pulmonary artery shunt the majority of time when early surgical intervention is required. We characterized a contemporary cohort of patients with TOF with pulmonary stenosis (PS) undergoing staged repair in order to determine the rate of pulmonary valve-sparing repair (PVSR), growth of the pulmonary valve annulus and pulmonary arteries, postoperative morbidity and mortality, and need for reintervention. Methods: We retrospectively studied patients with TOF/PS who underwent staged repair from 2000 to 2017. Surgical details, postoperative course, and reinterventions were noted. Echocardiographic measurements and Z-score values of pulmonary valve annulus, main pulmonary artery (MPA), right pulmonary artery (RPA), and left pulmonary artery (LPA) diameters were evaluated. Results: Of the 59 patients with staged TOF/PS, PVSR was performed in 25 (42%). There was a 5% incidence of postoperative arrhythmia. The Z-scores of MPA, RPA, and LPA were significantly higher before complete repair when compared to before palliative shunt. The 5 and 10-year survival rates were both 93%, and the probability of freedom from reoperation at 5 and 10 years was 87% and 82%, respectively. Conclusions: Staged repair of TOF in young symptomatic infants results in 42% receiving PVSR, pulmonary artery growth, low incidence of postoperative arrhythmia, and relatively low rate of reoperations.

Unexpected Internalization of a Pulmonary Artery Band in a Porcine Model of Tetralogy of Fallot

2016 ◽  
Vol 8 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Zakaria Jalal ◽  
François Roubertie ◽  
Emmanuelle Fournier ◽  
Virginie Dubes ◽  
David Benoist ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Histological Analysis ◽  
Porcine Model ◽  
Pulmonary Stenosis ◽  
Main Pulmonary Artery ◽  
Pulmonary Regurgitation ◽  
Inflammatory Cells ◽  
Pulmonary Insufficiency ◽  
Unusual Complication

Background: We report our experience of an unexpected complication of internalization of a pulmonary artery (PA) band in the vascular lumen, which occurred in a chronic porcine model of repaired tetralogy of Fallot (TOF). Methods: Twelve piglets were divided into 3 groups: (1) TOF model animals (PA band plus pulmonary valvotomy, n = 4), (2) pulmonary insufficiency (PI) animals (pulmonary valvotomy, n = 4), and (3) control animals (n = 4). A nonabsorbable, coated braided polyester tape was used to perform the main pulmonary artery banding. Echocardiography was performed 4 months postoperatively. After each animal was euthanized, PA histological analysis was performed in animals with band internalization. Results: Significant postsurgical pulmonary regurgitation and right ventricular enlargement were present in the TOF and PI, compared with control animals, whereas no significant pulmonary stenosis was observed in TOF animals when compared with PI group. Postmortem examination of all TOF animals revealed the constricting band to be intact but partially internalized into the PA lumen, allowing blood flow around the stenosis. Histological sections of the banded PA in the area of internalization showed a significant disorganization of the medial layer, with significant scarring and fibrotic reaction surrounding the outside of the band and the presence of inflammatory cells suggesting a significant inflammatory response during band internalization. Conclusions: Band internalization may occur after PA banding using a nonabsorbable, coated braided polyester tape in a chronic porcine model of repaired TOF. This unusual complication was likely due to the type of material used for banding.

Main pulmonary artery cross-section ratio is low in fetuses with tetralogy of Fallot and ductus arteriosus-dependent pulmonary circulation

2017 ◽  
Vol 27 (6) ◽  
pp. 1162-1166 ◽  
Author(s):  
Hironori Ebishima ◽  
Kenichi Kurosaki ◽  
Jun Yoshimatsu ◽  
Isao Shiraishi
Keyword(s):  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Cross Section ◽  
Pulmonary Circulation ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Cross Section Ratio ◽  
Section Ratio ◽  
Z Scores

AbstractObjectivesThis study aimed to determine fetal echocardiographic features of tetralogy of Fallot in association with postnatal outcomes.MethodsThe Z-scores of the main and bilateral pulmonary arteries and the aorta were measured, and the following variables were calculated in 13 fetuses with tetralogy of Fallot: pulmonary artery-to-aorta ratio and main pulmonary artery cross-section ratio – the main pulmonary artery diameter squared divided by the sum of the diameter squared of the left and right pulmonary arteries. Fetuses were classified as having ductus arteriosus-dependent or ductus arteriosus-independent pulmonary circulation.ResultsWe included two infants with pulmonary atresia and six infants with ductus-dependent pulmonary circulation, who underwent systemic-to-pulmonary shunt surgeries at ⩽1 month of age. The Z-scores of the main pulmonary artery and the pulmonary artery-to-aorta ratio in fetuses with ductus-dependent pulmonary circulation were lesser than those in fetuses with ductus independence, but not significantly. The main pulmonary artery cross-section ratio in fetuses with ductus dependence was significantly lesser (0.65±0.44 versus 1.56±0.48, p<0.005). Besides, the flow of the ductus arteriosus was directed from the aorta to the pulmonary artery in the ductus arteriosus-dependent group during the fetal period.ConclusionsThe main pulmonary artery cross-section ratio was the most significant variable for predicting postnatal outcomes in fetuses with tetralogy of Fallot.

Modified Repair of Tetralogy of Fallot with Absent Pulmonary Valve Syndrome

1996 ◽  
Vol 4 (3) ◽  
pp. 178-180
Author(s):  
Jacques AM van Son ◽  
Volkmar Falk ◽  
Friedrich W Mohr
Keyword(s):  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Pulmonary Valve ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Absent Pulmonary Valve ◽  
Modified Technique ◽  
Ventricular Compliance ◽  
Critically Ill Neonates ◽  
Absent Pulmonary Valve Syndrome

A modified technique for the repair of tetralogy of Fallot with absent pulmonary valve syndrome and stenosis at the origin of the lobar or segmental pulmonary artery branches is described. This consists of generous reduction plasty of the redundant anterior and posterior walls of the aneurysmally dilated branches of the pulmonary artery, resection of the main pulmonary artery, pericardial patch augmentation of the stenotic origins of the lobar or segmental pulmonary artery branches, insertion of a valved pulmonary allograft, and closure of the ventricular septal defect. The advantages of this technique, in addition to relief of the left-to-right shunt, consist of complete decompression of the tracheobronchial structures, and restoration of the capacitance of the central pulmonary arteries. This may result in a reduced tendency for postoperative respiratory insufficiency as well as long-term preservation of right ventricular compliance. The technique was successfully performed on 2 critically ill neonates and a 3-month-old infant.

Replacement of the aortic valve in tetralogy of Fallot prior to intracardiac repair—a case report

1992 ◽  
Vol 2 (2) ◽  
pp. 200-201 ◽  
Author(s):  
Giorgio M. Aru ◽  
Emiliano Cirio ◽  
Valentino Martelli
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Transesophageal Echocardiography ◽  
Tetralogy Of Fallot ◽  
Pulmonary Arteries ◽  
Jude Medical ◽  
Intracardiac Repair ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Septic Thrombosis

AbstractA 21-year-old woman with tetralogy of Fallot, who had undergone a right Blalock-Taussig shunt at one year of age, developed endocarditis of the aortic valve. Septic thrombosis of the right pulmonary artery was diagnosed by intraoperative transesophageal echocardiography. Replacement of the aortic valve initially performed by a St. Jude Medical prosthesis, was unsuccessful due to immobilization of the valve occluder. Subsequent replacement of the St. Jude valve by a Carpentier-Edwards valve was uneventful. Thrombectomy and patch enlargement of the right pulmonary artery were also performed successfully. We suggest that the St. Jude Medical valve should be employed with caution for replacement of the aortic valve in patients with tetralogy of Fallot who have not undergone intracardiac repair. Transesophageal echocardiography is extremely useful in discovering undiagnosed associated lesion such as septic thrombosis of the pulmonary arteries.

scholarly journals Single coronary artery with a fistula to the main pulmonary artery in a patient with tetralogy of Fallot

1977 ◽  
Vol 73 (5) ◽  
pp. 738-741 ◽  
Author(s):  
Joel I. Brenner ◽  
Lawrence R. Burwell ◽  
Marius M. Hubbell ◽  
Maury C. Newton ◽  
L. Jerome Krovetz ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Tetralogy Of Fallot ◽  
Main Pulmonary Artery ◽  
Single Coronary Artery
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