{"title":"Congenital disconnection of the pulmonary arteries","authors":"J. Karila Cohen, D. Bonnet","doi":"10.1016/j.acvdsp.2023.07.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span>Disconnected pulmonary artery is a rare anomaly that can be isolated or associated with complex intracardiac malformations. Early re-implantation of the disconnected pulmonary artery is recommended to allow growth and satisfactory pulmonary perfusion while preventing </span>collateral arteries development.</p></div><div><h3>Objective</h3><p>To describe the characteristics of patients with disconnected pulmonary artery and, for those who had surgical re-implantation, to determine the incidence, delay and predictive factors<span> of re-intervention for reconnected pulmonary artery stenosis.</span></p></div><div><h3>Methods</h3><p>We include patient with diagnosis of congenitally disconnected PA and surgical repair at our institution.</p></div><div><h3>Results/Expected results</h3><p>Retrospective observational study of 55 patients with a disconnected pulmonary artery. Fifty-one underwent surgical correction and were followed up at our institution between 2000 and 2022.</p><p><span>Disconnected pulmonary arteries were observed in isolation in 31% of the cases. The most frequent form was left pulmonary artery originating from the arterial duct (58%). The re-implantation was done at median age of 12 days. Anastomotic stenosis was observed during follow-up in 71% of the patients with 75% of them requiring re-intervention (55% of the population). The median delay to re-intervention was 3.2 years after re-implantation, and more than 25% of re-interventions on the re-implanted pulmonary artery occurred within the first postoperative year. We found more re-intervention if associated cardiac defect, without significant statistic difference. Weight at re-confluence, presence of ductal tissue at the origin of the pulmonary artery, and prior shunt placement on the disconnected pulmonary artery were not found to be risk factors for re-intervention (</span><span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>After surgical re-implantation of pulmonary artery, more than 50% of patients required re-intervention for pulmonary artery stenosis. Technical improvements should be sought to reduce incidence of this complication.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases Supplements","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S187864802300232X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Disconnected pulmonary artery is a rare anomaly that can be isolated or associated with complex intracardiac malformations. Early re-implantation of the disconnected pulmonary artery is recommended to allow growth and satisfactory pulmonary perfusion while preventing collateral arteries development.
Objective
To describe the characteristics of patients with disconnected pulmonary artery and, for those who had surgical re-implantation, to determine the incidence, delay and predictive factors of re-intervention for reconnected pulmonary artery stenosis.
Methods
We include patient with diagnosis of congenitally disconnected PA and surgical repair at our institution.
Results/Expected results
Retrospective observational study of 55 patients with a disconnected pulmonary artery. Fifty-one underwent surgical correction and were followed up at our institution between 2000 and 2022.
Disconnected pulmonary arteries were observed in isolation in 31% of the cases. The most frequent form was left pulmonary artery originating from the arterial duct (58%). The re-implantation was done at median age of 12 days. Anastomotic stenosis was observed during follow-up in 71% of the patients with 75% of them requiring re-intervention (55% of the population). The median delay to re-intervention was 3.2 years after re-implantation, and more than 25% of re-interventions on the re-implanted pulmonary artery occurred within the first postoperative year. We found more re-intervention if associated cardiac defect, without significant statistic difference. Weight at re-confluence, presence of ductal tissue at the origin of the pulmonary artery, and prior shunt placement on the disconnected pulmonary artery were not found to be risk factors for re-intervention (Figure 1).
Conclusion/Perspectives
After surgical re-implantation of pulmonary artery, more than 50% of patients required re-intervention for pulmonary artery stenosis. Technical improvements should be sought to reduce incidence of this complication.
期刊介绍:
Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.