Effects of Angle Correction Angioplasty for Pulmonary Artery Stenosis With Tetralogy of Fallot
- Author(s)
- Woo Sung Jang; Woong-Han Kim; Sungkyu Cho
- Keimyung Author(s)
- Jang, Woo Sung
- Department
- Dept. of Thoracic & Cardiovascular Surgery (흉부외과학)
- Journal Title
- Annals of Thoracic Surgery
- Issued Date
- 2017
- Volume
- 103
- Issue
- 3
- Abstract
- Background :
Left pulmonary artery (LPA) stenosis with acute angulation is a common cause of reoperation after tetralogy of Fallot repair. We therefore investigated surgical outcomes of acute-angle correction angioplasty.
Methods:
Between 2005 and 2012, 53 patients underwent operation for LPA stenosis as a concurrent procedure. We divided the patients into two groups according to the LPA ostium angulation: group I (acute angle, acute-angle correction angioplasty, n = 29) and group II (obtuse angle, conventional patch angioplasty, n = 24), encompassing subgroup type I (focal stenosis) and type II (diffuse stenosis). The changes in the z score of LPA and lung perfusion rates were monitored using computed tomography and lung perfusion scans.
Results:
The z scores of LPA ostium and hilum were improved at 4.9 mean years of follow-up in group I (p = 0.002, p = 0.041). At the most recent follow-up, there were no differences in the LPA z score (p = 0.177; n = 16 in group I; n = 13 in group II) or left lung perfusion rates (group I: 39.5% ± 9.6%, n = 26; group II: 36.8% ± 11.2%, n = 18, p = 0.418) between the two groups. In group I, the ostial z scores and lung perfusion rates in patients with type II (−4.1 ± 3.1, 25.4%) were lower than patients with type I (−1.6 ± 2.5, 41.0%) at the most recent follow-up (p = 0.069, p = 0.001, respectively). The reoperation or reintervention rate was higher in patients with type II than in patients with type I in group I (p = 0.022).
Conclusions:
Acute-angle correction angioplasty was associated with similar LPA ostium z scores and left lung perfusion rates in the two groups. Diffuse LPA stenosis compromised left lung perfusion and increased reoperation or reintervention rate.
- Authorize & License
-
- Authorize공개
- EmbargoForever
- Files in This Item:
-
Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.