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Right ventricular outflow tract transannular patch placement without cardiopulmonary bypass.
D S Levi1, J P Glotzbach2, R J Williams3
1Divisions of Pediatric Cardiology, Mattel Children's Hospital at UCLA, B2-427 MDCC, Los Angeles, CA, 90095-1743, USA. dlevi@ucla.edu.
Pediatric Cardiology
|November 2, 2005
Summary
Off-pump right ventricular outflow tract (RVOT) patch enlargement is a safe and effective surgical option for children with pulmonary atresia. This technique successfully establishes antegrade pulmonary blood flow without cardiopulmonary bypass.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
Background:
- Pulmonary atresia requires surgical intervention to establish pulmonary blood flow.
- Right ventricular outflow tract (RVOT) patch enlargement is a common surgical technique.
Purpose of the Study:
- To evaluate the safety and efficacy of off-pump RVOT transannular patch (TAP) augmentation in children with pulmonary atresia.
- To assess the feasibility of performing RVOT enlargement without cardiopulmonary bypass.
Main Methods:
- Retrospective review of 22 consecutive pediatric patients undergoing off-pump RVOT TAP augmentation.
- Procedure performed between March 1993 and October 2004 with cardiopulmonary bypass on standby.
Main Results:
- Twenty of 22 patients tolerated the off-pump procedure.
- Adequate antegrade pulmonary blood flow was achieved in all patients.
- No operative mortalities or complications were observed; one late death from myocardial ischemia.
Conclusions:
- Transannular RVOT patch augmentation can be performed safely and effectively without cardiopulmonary bypass.
- Off-pump TAP augmentation is a viable option for select pediatric patients with pulmonary atresia.
- This approach facilitates adequate pulmonary blood flow with good outcomes.
