Sangawa K, Oba O, Nakanishi K, Okada M, Yoshida H, Shiote A
Department of Cardiovascular Surgery, Hiroshima City Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Nov;41(11):2196-201.
Two patients undergoing corrective operation for pulmonary atresia with ventricular septal defect associated with major aortopulmonary collateral arteries (MAPCAs) were reported. Both patients underwent staged surgical repair, first stage: unifocalization, and second stage: Rastelli type operation. Case 1 was a 13-year-old female who had a confluent central pulmonary artery and 1 MAPCA, unifocalized at 10 years of age. After the corrective operation, the ratio between peak right ventricular and peak left ventricular pressure (pRV/LV) was 0.5 and she followed a satisfactory post-operative course. Case 2 was a 11-year-old female who had a severe hypoplastic central pulmonary artery (3 mm in diameter) and 3 MAPCAs, and she underwent unifocalization twice. After the corrective operation, pRV/LV was 0.65 and her postoperative course was also satisfactory.