The literature describes multiple approaches for the repair of stenosed branch pulmonary arteries. Regardless of the technique, restenosis is undesirably and notoriously common. We describe a case of severe left pulmonary artery stenosis repaired with a novel technique in consideration of factors leading to restenosis. The native main pulmonary artery was transected and turned down to create a direct anastomosis with the left pulmonary artery. The child had a normal sized main pulmonary artery with tricuspid atresia and pulmonary atresia with ductus arteriosus feeding the severely stenosed left pulmonary artery. Our novel technique resulted in hemodynamically gratifying results with a tension free tissue-tissue anastomosis with potential for growth.
There are multiple surgical approaches described to repair the left pulmonary artery (LPA). Regardless of the technique used, rate of restenosis is very high. We describe a case of discontinuous LPA which was treated by turning down the entire autologous main pulmonary artery (MPA) and creating a direct anastomosis between the MPA and LPA. This was in background of tricuspid and pulmonary atresia, hypoplastic right ventricle with atrial and ventricular septal defects and ductus arteriosus feeding the left pulmonary artery. This new technique resulted in a tension free tissue-tissue anastomosis with potential for growth and produced hemodynamically gratifying short-term results.
We present a rare case of atrial septal defect and ventricular septal defect with a vascular ring. The ring was formed by a right-sided aortic arch with an aberrant left subclavian artery that gave rise to a patent ductus arteriosus connecting to the main pulmonary artery. We performed a single-stage repair of the intra-cardiac defects and division of vascular ring with a novel sternotomy approach instead of the traditionally practised dual approach. Our novel approach included implantation of the aberrant left subclavian artery to the left carotid artery after transection. We could perform single-stage division of vascular ring along with the closure of both septal defects.