Anomalous origin of pulmonary artery branch from aorta ascendens-
Outcome of patients who underwent direct re-implantation
Abstract
Background: Anomalous origin of pulmonary artery branch from ascending
aorta(AOPA) in the presence of two separate semilunar valves is a rare
but important entity necessitating early diagnosis and surgery to
prevent development of irreversible pulmonary vascular disease. We
evaluated our experience with the technique and outcome of eleven
patients with this condition. Methods: Between January 2000 and December
2018, eleven patients were diagnosed with AOPA. Echocardiographic data
were collected from the records, regarding the site of origin of the
anomalous pulmonary artery, additional defects, biventricular function
and pulmonary artery pressures. Intraoperative charts were reviewed for
the details of the surgical procedure and cardiopulmonary bypass.
Postoperative data included survival, ventilatory support and duration
of hospital stay. After discharge, children were reviewed at 1 month, 3
months, 6 months and then at yearly intervals. Results: Of the eleven
patients, male to female ratio was 4:7 with a median age of six
months(15 days - 28 years) and median weight of 5.7 kg(1.8 kg - 40 kg).
Nine patients underwent direct re-implantation of anomalous pulmonary
artery branch to main pulmonary artery. The survival rate was 91% in
our series. On follow-up, no re-operations or re-interventions were
required and all patients who underwent surgical correction were in
stable clinical condition. Conclusion: Early and midterm outcomes of
children who underwent surgery for AOPA is good. Early direct
re-implantation of the anomalous branch PA to main pulmonary artery is
the optimal surgical strategy for these patients