Absent pulmonary valve syndrome: operation in infants with airway obstruction

Research output: Contribution to journalArticle

Abstract

From 1979 through 1991, 19 infants with absent pulmonary valve syndrome and airway obstruction were seen for surgical treatment. All patients underwent extensive pulmonary artery aneurysmorrhaphy using cardiopulmonary bypass. Fourteen patients had simultaneous transatrial ventricular septal defect (VSD) closure, infundibular resection, and placement of a short transannular patch; 2 had transventricular VSD closure and infundibular resection without a transannular patch; 1 underwent transventricular VSD closure and transannular patching; and 2 underwent pulmonary artery aneurysmorrhaphy alone with the VSD left open. All 19 infants had good hemodynamics when taken from the operating theater, but 3 died postoperatively of severe airway obstruction, despite further tracheobronchopexy procedures in 2 (hospital mortality rate, 16%; confidence limits, 7% to 29%). Among the 16 patients discharged from the hospital, there was one late death. Five other patients have required reoperation for branch pulmonary artery stenosis (n = 2), residual airway obstruction resulting from persistent pulmonary artery dilatation (n = 1), closure of VSD (n = 1), and homograft valve insertion for pulmonary incompetence and right ventricular dysfunction (n = 1). There are 15 long-term survivors. Eight of them have episodic bronchospasm of mild to moderate severity, and all are responsive to sympathomimetic bronchodilator aerosols. The remaining 7 are asymptomatic.

Details

Authors
External organisations
  • Royal Children's Hospital, Melbourne
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Surgery
  • Pediatrics

Keywords

  • Airway Obstruction/complications, Cardiac Surgical Procedures/methods, Cardiopulmonary Bypass/methods, Congenital Abnormalities/mortality, Female, Follow-Up Studies, Hospital Mortality, Hospitals, Pediatric, Humans, Infant, Infant, Newborn, Male, Pulmonary Valve/abnormalities, Reoperation/statistics & numerical data, Survival Rate, Treatment Outcome, Victoria/epidemiology
Original languageEnglish
Pages (from-to)1116-9
Number of pages4
JournalAnnals of Thoracic Surgery
Volume54
Issue number6
Publication statusPublished - 1992 Dec
Publication categoryResearch
Peer-reviewedYes
Externally publishedYes