Korean J Thorac Cardiovasc Surg.  2003 Apr;36(4):255-260.

A New Technique of Angioplasty of the Left Pulmonary Artery Using an Autologous Main Pulmonary Artery Flap

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Gachon Medical School, Gil Medical Center, Korea. leechha@ghil.com
  • 2Department of Thoracic and Cardiovascular Surgery, Wallace Memorial Baptist Hospital, Busan, Korea.
  • 3Department of Thoracic and Cardiovascular Surgery, Chosun University Hospital, Korea.
  • 4Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institution, Korea.
  • 5Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University, Korea.

Abstract

BACKGROUND: Stenosis of the left pulmonary artery (LPA) after repair of tetralogy of Fallot (TOF) is troublesome. A new technique of LPA angioplasty using an autologous MPA flap was performed in patients with TOF. MATERIALAND METHOD: From October 1998 to January 2001, 24 patients (median age; 10 months, range; 4 to 145 months)underwent total correction of TOF with LPA angioplasty using the autologous MPA flap. Five patients underwent pulmonary angioplasty without any patch over the MPA and LPA. The patches were required to enlarge only the MPA in 4 patients, and transannular RVOT widening was performed in 15. RESULT: There were no operative or late deaths. During follow-up (range: 6~42 months), reoperation for LPA stenosis was not required in any patients, but balloon angioplasty for branch pulmonary artery stenosis was performed in 3 patients. Echocardiography and CT angiography at the recent follow-up showed an obtuse angle between the MPA and LPA.
CONCLUSION
Although further follow-up is needed, the angioplasty using the autologous MPA flap can be easily performed, avoiding patch-related complications, and allowing growth of the MPA flap. This angioplasty technique creates a more natural and obtuse angle between the MPA and LPA, which can minimize kinking of the LPA, especially in the patients who underwent transannular patch widening.

Keyword

Tetralogy of Fallot; Surgery method; Angioplasty, surgical

MeSH Terms

Angiography
Angioplasty*
Angioplasty, Balloon
Constriction, Pathologic
Echocardiography
Follow-Up Studies
Humans
Pulmonary Artery*
Reoperation
Tetralogy of Fallot
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