HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Amodeo, A. Articles by Monro, J. L. Search for Related Content PubMed PubMed Citation Articles by Amodeo, A. Articles by Monro, J. L.

European Journal of Cardio-Thoracic Surgery, Vol 5, 17-21, Copyright © 1991 by European Association for Cardio-thoracic Surgery

ARTICLES

Pulmonary atresia with intact ventricular septum: is neonatal repair advisable?

A Amodeo, BR Keeton, GR Sutherland and JL Monro
Wessex Cardiothoracic Centre, Southampton General Hospital, Southampton, UK.

The optimal management of pulmonary atresia with an intact ventricular septum in the neonate remains controversial. The introduction of balloon septostomy and prostaglandin has significantly reduced early mortality but early surgical intervention is necessary to obtain a more adequate pulmonary blood flow. Fourteen neonates with pulmonary atresia and an intact ventricular septum were admitted to the Wessex Cardiothoracic Unit, Southampton from 1979 to 1986. Thirteen patients underwent cardiac catheterization. Cardiac catheterization data and right ventricular angiograms were reviewed retrospectively. Four patients with tripartite ventricles underwent total repair. The others received various palliative operations (valvotomy + modified Blalock- Taussig shunt or modified Blalock-Taussig shunt alone). Retrospective analysis of the angiograms indicated that right ventricular morphology alone is not a satisfactory criterion for surgical management. We have been able to demonstrate that there is a good correlation between the diameter of the tricuspid valve and the diameter of the infundibulum and that successful neonatal repair is possible when the tricuspid valve diameter is above 80% of the normal value for weight and when the tricuspid valve diameter to infundibular diameter ratio (TV/Inf ratio) is 2.2 or less. In patients with a tripartite ventricle but inadequate TV diameter and TV/Inf ratio, a closed pulmonary valvotomy with a modified Blalock-Taussig shunt remains the treatment of choice.

This article has been cited by other articles:

				P. E.F. Daubeney, D. Wang, D.J. Delany, B.R. Keeton, R.H. Anderson, Z. Slavik, M. Flather, S.A. Webber, and for the UK and Ireland Collaborative Study of Pulm Pulmonary atresia with intact ventricular septum: Predictors of early and medium-term outcome in a population-based study J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1071 - 1071. [Abstract] [Full Text] [PDF]