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Staged repair of hemitruncus without prosthetic material
Takashi Kido1, Takaya Hoashi1, Koji Kagisaki1
1Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Asian Cardiovascular & Thoracic Annals
|November 7, 2015
Summary
Right pulmonary artery banding successfully treated a neonate with right hemitruncus, improving pulmonary hypertension and right ventricular function. Complete correction was achieved, with normal cardiac function at one year.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Surgical Intervention
Background:
- Right hemitruncus is a rare congenital heart defect characterized by a single great artery arising from the ventricles, supplying both pulmonary and systemic circulations.
- Severe pulmonary hypertension and impaired right ventricular contraction in neonates with right hemitruncus pose significant management challenges.
Observation:
- A 17-day-old infant diagnosed with right hemitruncus presented with severe pulmonary hypertension and severely reduced right ventricular contraction.
- The patient underwent right pulmonary artery banding as an initial palliative procedure.
Findings:
- Following pulmonary artery banding, gradual improvement in pulmonary hypertension and right ventricular contraction was observed with the administration of pulmonary vasodilators.
- Total surgical correction was successfully performed two months after the initial banding procedure.
- A one-year cardiac catheterization follow-up revealed normal pulmonary artery pressures and preserved right ventricular function.
Implications:
- Right pulmonary artery banding can be an effective initial strategy in managing neonates with right hemitruncus and severe pulmonary hypertension.
- This approach allows for hemodynamic stabilization, facilitating subsequent complete surgical correction.
- Successful surgical management leads to long-term normalization of pulmonary artery pressures and ventricular function in patients with right hemitruncus.
