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Salve GG, Memon DA, Manvi V, Manvi NG, Gan MD, Saldanha R. Technique of interdigitating flaps for repair of abnormal origin of right pulmonary artery from ascending aorta. JTCVS Tech 2024; 25:136-140. [PMID: 38899109 PMCID: PMC11184663 DOI: 10.1016/j.xjtc.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 06/21/2024] Open
Affiliation(s)
- Gananjay G. Salve
- Department of Cardiovascular & Thoracic Surgery, KLE's Dr Prabhakar Kore Hospital & Medical Research Centre, Belgaum, Karnataka, India
| | - Danish A.K. Memon
- Department of Paediatric Cardiology, KLE's Dr Prabhakar Kore Hospital & Medical Research Centre, Belgaum, Karnataka, India
| | - Veeresh Manvi
- Department of Paediatric Cardiology, KLE's Dr Prabhakar Kore Hospital & Medical Research Centre, Belgaum, Karnataka, India
| | - Nidhi G. Manvi
- Department of Paediatric Cardiology, KLE's Dr Prabhakar Kore Hospital & Medical Research Centre, Belgaum, Karnataka, India
| | - Mohan D. Gan
- Department of Cardiovascular & Thoracic Surgery, KLE's Dr Prabhakar Kore Hospital & Medical Research Centre, Belgaum, Karnataka, India
| | - Richard Saldanha
- Department of Cardiovascular & Thoracic Surgery, KLE's Dr Prabhakar Kore Hospital & Medical Research Centre, Belgaum, Karnataka, India
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Wu SJ, Downing T, Mascio C, Gillespie MJ, Dori Y, Rome JJ, Glatz AC. Reintervention Burden and Vessel Growth After Surgical Reimplantation of a Pulmonary Artery During Childhood. Pediatr Cardiol 2018; 39:390-397. [PMID: 29098350 DOI: 10.1007/s00246-017-1767-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/28/2017] [Indexed: 11/26/2022]
Abstract
Children requiring reimplantation of a branch pulmonary artery (PA) are at risk for postoperative stenosis and impaired growth of the reimplanted PA. Outcomes and risk factors for reintervention and impaired growth are incompletely described. We reviewed data on patients who underwent reimplantation of a branch PA between 1/1/99 and 5/1/15 at a single center. The primary outcome was reintervention to treat postoperative stenosis. The secondary outcome was "catch-up" growth (faster diameter growth of the affected PA compared with the unaffected PA from the preoperative to follow-up measurements.). Twenty-six patients were identified with a total follow-up of 102.2 patient-years (median 2.5 years). Diagnoses included LPA sling (n = 12) and isolated PA of ductal origin with (n = 7) or without (n = 7) tetralogy of Fallot (ToF). All had primary repair of the anomalous PA. Seventeen (65%) had reintervention with median time to first reintervention of 69 (range 1-1005) days and median of 1.5 (range 1-6) reinterventions. 94% of reinterventions were transcatheter (53% balloon and 41% stent angioplasty). Patients with reintervention were younger (hazard ratio 0.75 per log-day, p = 0.02) and lower weight (hazard ratio 0.18 per log-kg, p = 0.02) at initial repair. Of the 18 with PA growth data, 8 (44%) had catch-up growth. There were no identified differences between those who did and did not demonstrate catch-up growth. Despite a practice of primary reimplantation and aggressive postoperative reintervention, these results suggest that changes in strategy are needed or that there are intrinsic patient factors that have more influence on longer-term reimplanted PA growth.
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Affiliation(s)
- Stephan J Wu
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 6th Floor Main Building, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Tacy Downing
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 6th Floor Main Building, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA
- Nicklaus Children's Hospital, Miami, FL, USA
| | - Christopher Mascio
- Division of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew J Gillespie
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 6th Floor Main Building, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Yoav Dori
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 6th Floor Main Building, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Jonathan J Rome
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 6th Floor Main Building, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Andrew C Glatz
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 6th Floor Main Building, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA.
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