European Journal of Cardio-Thoracic Surgery, Vol 1, 110-115, Copyright © 1987 by European Association for Cardio-thoracic Surgery
Truncus arteriosus type A3: complex repair with cryopreserved pulmonary homograft
G Ziemer, I Luhmer, F Siclari and HC Kallfelz
Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Federal Republic of Germany.
A 6-year-old girl with truncus arteriosus type A3, one of the rarest
anatomic types, underwent corrective surgery using a cryopreserved valved
pulmonary homograft. The special anatomic features in this case were
individual origin of the pulmonary arteries. The right pulmonary artery
came directly off the truncal vessel, whereas the left pulmonary artery was
connected to the aortic arch via a stenotic ductus or ductus- like vessel.
The preoperative pulmonary blood flow distribution was 94% on the right
versus 6% on the left side. The underperfusion of the left lung may have
been related to pulmonary hypoplasia due to long lasting stenosis at the
left pulmonary artery take off. The postoperative pulmonary blood flow
distribution was 67% on the right versus 33% on the left side. The
operative and postoperative course has been uneventful; presently, 6 months
after the operation, the patient is in improved clinical condition.