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The Longest Documented Postoperative Survivor of a Brock Procedure 63 Years Later
Navyatha Mohan1, Masood Ahmad2, Ghannam Al Dossari1
1Division of Cardiothoracic Surgery, Department of Surgery, University of Texas Medical Branch at Galveston, Galveston, Texas.
Insights
This case study highlights the longest reported survivor of a Brock procedure for critical pulmonary valve stenosis, demonstrating long-term positive outcomes 63 years post-surgery. The patient successfully managed recurrent stenosis and a large pulmonary artery aneurysm.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Medical Case Reports
Background:
- The patient, diagnosed with critical pulmonary valve stenosis in infancy, underwent a palliative Brock procedure in 1957.
- Subsequent surgical interventions included repair of pulmonary stenosis and an atrial septal defect (ASD) at age 6, and repair of paradoxical embolization due to a residual ASD at age 17.
Observation:
- The patient presented 54 years after the initial Brock procedure with recurrent pulmonary stenosis.
- A symptomatic 6.2-cm pulmonary artery aneurysm was identified and subsequently repaired using a 23-mm aortic homograft.
Findings:
- This case represents the longest documented postoperative survival following a Brock procedure.
- The patient remains in good health 63 years after her initial cardiac surgery.
Implications:
- This report underscores the potential for exceptional long-term survival and quality of life in patients undergoing early palliative cardiac procedures for congenital heart defects.
- It highlights the importance of lifelong surveillance for patients with complex congenital heart disease, even decades after initial interventions.
- The successful management of late complications, such as pulmonary artery aneurysm, demonstrates the feasibility of advanced surgical repairs in long-term survivors.
Abstract:
An infant with critical pulmonary valve stenosis underwent a Brock procedure in 1957 with subsequent repair of pulmonary stenosis and an atrial septal defect at age 6. At age 17 she underwent repair for paradoxical embolization secondary to a residual atrial septal defect. She presented 54 years later with recurrent pulmonary stenosis and a symptomatic 6.2-cm pulmonary artery aneurysm repaired with a 23-mm aortic homograft. This patient is the longest reported postoperative survivor after a Brock procedure. She continues to do well 63 years after her initial surgery.
