Surgical Results of Anomalous Origin of the Right Pulmonary Artery From the Ascending Aorta Including Reoperation for Infrequent Complications

Noriyoshi Kajihara, Yutaka Imoto, Masato Sakamoto, Yukie Ochiai, Meikun Kan-o, Kunitaka Joo, Mamie Watanabe, Tetsuji Yuge, Toshihide Asou, Yuko Takeda, Akira Sese

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

Background: We evaluated the results of surgery for an anomalous origin of the right pulmonary artery from the ascending aorta. Methods: From August 1986 to December 2005, 8 children (6 neonates) aged 7 to 180 days (mean, 35 ± 59 days) with anomalous origin of the right pulmonary artery from the ascending aorta underwent surgical repair at our institute. All except one child, who had the distal form, had the proximal form. Cardiac catheterization showed that the left pulmonary artery to systemic pressure ratio was 1.0 or more. Surgery was performed by direct anastomosis in 7 patients and by graft interposition in 1. Results: There were no operative or late deaths. All patients postoperatively underwent cardiac catheterization that showed decreased left pulmonary artery to systemic pressure ratio ranging from 0.2 to 0.6. Follow-up periods ranged from 2 months to 13 years. We undertook reoperations for two infrequent postoperative causes. One patient exhibited significant supravalvar aortic stenosis and required patch enlargement of the ascending aorta 3 years after operation. The other patient (with the distal form) needed a reoperation after 1 month because of progressive stenosis at the anatomic site. Graft interposition was performed, and histopathologic examination showed that the tissue from the stenotic region looked like that of a ductus. Conclusions: We undertook surgical repair for anomalous origin of the right pulmonary artery from the ascending aorta. Pulmonary hypertension was improved in all patients. Careful follow-up was necessary to detect supravalvar aortic and anastomotic stenosis early and late after operation.

Original languageEnglish
Pages (from-to)1407-1411
Number of pages5
JournalAnnals of Thoracic Surgery
Volume85
Issue number4
DOIs
Publication statusPublished - Apr 2008

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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