Related Experiment Video
Updated: Dec 15, 2025
Donor Posterior Atrial Flap Rotation for Left Atrial Cuff Reconstruction in Lung Transplantation
Published on: October 11, 2024
Repair of pulmonary artery sling with tracheal and intracardiac defects
Nagarajan Muthialu1, Thomas Martens1, Meletios Kanakis1
1Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK.
Insights
Pulmonary artery sling repair in children can achieve good outcomes despite airway or heart defects. Longer cardiopulmonary bypass time and lung abnormalities are key risk factors for mortality.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
- Thoracic Surgery
Background:
- Pulmonary artery sling is often linked with tracheal stenosis and intracardiac anomalies.
- Surgical repair outcomes are influenced by coexisting conditions, necessitating risk stratification.
Purpose of the Study:
- To review surgical outcomes of complex pulmonary artery sling repair.
- To identify risk factors for surgical outcomes in patients with associated airway or intracardiac lesions.
Main Methods:
- Retrospective evaluation of 79 children undergoing pulmonary artery sling repair.
- Surgical approaches included isolated repair, repair with tracheoplasty, or repair with combined intracardiac and tracheal procedures.
Main Results:
- Overall early mortality was 8.8%, with longer ICU and hospital stays for those with tracheal surgery.
- Univariate analysis identified abnormal lungs and structural heart disease as risk factors.
- Multivariate analysis indicated total cardiopulmonary bypass time as an independent predictor of mortality.
Conclusions:
- Complex pulmonary artery sling repair is feasible with good outcomes, even with associated anomalies.
- Lung abnormalities and prolonged cardiopulmonary bypass time are potential risk factors for adverse outcomes.
Background:
Pulmonary artery sling is commonly associated with tracheal stenosis and intracardiac anomalies. While surgical repair is standardized, coexistent anomalies often determine outcomes. With the paucity of risk stratification, this study aimed to review our experience and stratify risk factors for the surgical outcome of complex pulmonary artery sling repair in the presence of airway or intracardiac lesions.
Methods:
Seventy-nine consecutive children with pulmonary artery sling were evaluated retrospectively following surgical repair. Median age at surgery was 5 months (interquartile range 3-9). Surgical approaches included pulmonary artery sling alone (n = 10), pulmonary artery sling with tracheoplasty (n = 41), and pulmonary artery sling with both intracardiac and tracheal surgery (n = 28).
Results:
There were 7 early (8.8%) deaths. Two patients after left pulmonary artery reimplantation needed revision of the anastomosis. The median intensive care and hospital stay were 11 (interquartile range 9.2-24.8) and 17.9 (interquartile range 4.3-19.8) days, and considerably longer when associated tracheal surgery (p = 0.002). Follow-up was complete in 66/69 and 3 (3.8%) children died late: 2.7, 10.2, and 17 months after surgery. Univariate analysis showed abnormal lung and coexisting structural heart disease as risk factors. Multivariate analysis revealed total cardiopulmonary bypass time as an independent predictor of overall mortality.
Conclusion:
Complex pulmonary artery sling repair can be performed with a good surgical outcomes even when associated with airway malformations or structural heart diseases. Lung abnormality and longer cardiopulmonary bypass time as a surrogate marker of complex surgery, are possible risk factors.
More Related Videos
13:10Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
Published on: April 24, 2017
10:39Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding
Published on: August 30, 2024
