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Eur J Cardiothorac Surg 2006;29:865
© 2006 Elsevier Science NL

Letter to the Editor

Reply to Ugurlucan et al.

Department of Thoracic and Cardiovascular Surgery, Clinical Research Institute, Seoul National University Children's Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea

Received 10 February 2006; accepted 13 February 2006.

^_* Corresponding author. Tel.: +82 2 7603637; fax: +82 2 36723637. (Email: woonghan{at}snu.ac.kr).

Key Words: Single ventricle • Modified BT shunt • Bidirectional Glenn shunt • Fontan procedure

We are grateful to Dr Tireli and colleagues from the University of Istanbul for their comments on our article [1]. We agree with them that central shunt provides sufficient and bidirectional symmetrical pulmonary blood flow and promotes growth of the pulmonary arteries [2]. However, for patients with significant juxtaductal pulmonary coarctation, pulmonary angioplasty should be performed at an early stage when gap between the bilateral pulmonary arteries is still small, and appropriate growth of the pulmonary artery is attainable [3,4].

We performed the modified Blalock–Taussig shunt with concomitant pulmonary angioplasty only in 13 patients of total of 137 patients who underwent MBTS between September 1998 and August 2002. All the 13 patients had significant pulmonary coarctation diagnosed with echocardiography and/or chest CT. This procedure rendered these patients had good candidate for the Fontan procedure by maintenance of even pulmonary blood flow bilaterally.

Central shunt would be good option for nonsignificant pulmonary coarctation. However, in case of significant pulmonary coarctation, pulmonary angioplasty is mandatory for subsequent procedure.

References

1. Kim HK, Kim WH, Kim SC, Lim C, Lee CH, Kim SJ. Surgical strategy for pulmonary coarctation in the univentricular heart. Eur J Cardiothorac Surg 2006;29:100-104.[Abstract/Free Full Text]
2. Potapov EV, Alexi-Meskishvili VV, Dahnert I, Ivanitskaia EA, Lange PE, Hetzer R. Development of pulmonary arteries after central aortopulmonary shunt in newborns. Ann Thorac Surg 2001;71:899-905.[Abstract/Free Full Text]
3. Barbero-Marcial M, Atik E, Baucia JA, Pradel HOV, Macruz R, Jatene AD. Reconstruction of stenotic or nonconfluent pulmonary arteries simultaneously with a Blalock–Taussig shunt. J Thorac Cardiovasc Surg 1988;95:82-89.[Abstract]
4. Ishibashi N, Koide M, Uchita S, Seguchi M. When should pulmonary artery angioplasty be performed for Fontan candidates with pulmonary coarcatation? Two cases of pulmonary artery angioplasty with the Blalock–Taussig shunt on pump in neonates. Jpn J Thorac Cardiovasc Surg 2004;52:185-188.[Medline]

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 Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hyun Koo Kim Woong-Han Kim Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kim, H. K. Articles by Kim, W.-H. Search for Related Content PubMed Articles by Kim, H. K. Articles by Kim, W.-H. Related Collections Congenital - cyanotic