The surgical treatment of anomalous origin of one pulmonary artery from the ascending aorta

J Cardiothorac Surg. 2019 Apr 27;14(1):82. doi: 10.1186/s13019-019-0904-0.

Abstract

Objective: This study sought to summarize the clinical experience of surgical treatment of anomalous origin of pulmonary arteries from the ascending aorta (AOPA) in Fuwai hospital.

Methods: Fifty-two patients (28 males, 17.2 ± 27.2 months old and 8.7 ± 10.2 Kg weight) who have AOPA undertook surgical treatment between 1998 and 2017 were reviewed in this study, 47 out of 52 are anomalous origin of the right pulmonary artery (AORPA), among the rest of the patients are anomalous origin of left pulmonary artery (AOLPA). 27 out of 52 associate with simple cardiac abnormalities, 20 out of 52 associate with complex cardiac malformations, the remaining 5 patients without cardiac abnormalities. Among all patients who underwent surgical treatment, the direct end-to-side anastomosis strategy was applied in 26 patients, autologous pericardial-homograft patch and aortic flap were employed in 20 patients, and synthetic graft was used in 6 patients.

Results: No patient died during the perioperative period. 50 out of 52 patients were followed-up for 100.1 ± 70.9 months. The rate of pulmonary arterial free restenosis for 2 years, 5 years, and 10 years is 98.0, 96.0 and 92.0%, respectively.

Conclusions: The correct diagnosis and appropriate surgical treatment for AOPA could obtain excellent early and medium-term result.

Keywords: Anomalous origin of pulmonary artery; Congenital heart disease; Pulmonary hypertension.

MeSH terms

  • Adolescent
  • Anastomosis, Surgical
  • Aorta / abnormalities
  • Aorta / surgery*
  • Aorta / transplantation
  • Cardiovascular Abnormalities / surgery*
  • Cardiovascular Surgical Procedures
  • Child
  • Child, Preschool
  • Female
  • Heart Defects, Congenital / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Pericardium / transplantation
  • Pulmonary Artery / abnormalities
  • Pulmonary Artery / surgery*
  • Pulmonary Artery / transplantation
  • Retrospective Studies
  • Surgical Flaps
  • Treatment Outcome
  • Young Adult