Subject(s)
Aortic Coarctation/surgery , Hypoplastic Left Heart Syndrome/surgery , Surgical Flaps , Angioplasty, Balloon , Aorta, Thoracic/abnormalities , Aortic Coarctation/complications , Female , Humans , Hypoplastic Left Heart Syndrome/complications , Infant, Newborn , Postoperative Complications/therapy , Subclavian Artery/surgeryABSTRACT
A 13-year-old boy with tetralogy of Fallot and pulmonary atresia after a Waterston and Blalock-Taussig shunt underwent successful repair using a cryopreserved pulmonary homograft as a valved extracardiac conduit. Aortic transection gave a good operative field for pulmonary angioplasty and closure of the Waterston anastomosis. The cryopreserved pulmonary homograft provided excellent handling characteristics. The postoperative course was good, and postoperative echocardiography showed good function of the valved conduit.
Subject(s)
Pulmonary Artery/transplantation , Pulmonary Atresia/surgery , Tetralogy of Fallot/surgery , Adolescent , Anastomosis, Surgical , Cryopreservation , Hemodynamics , Humans , Male , Pulmonary Atresia/complications , Pulmonary Atresia/physiopathology , Tetralogy of Fallot/complications , Tetralogy of Fallot/physiopathology , Transplantation, Homologous , Vascular Surgical ProceduresABSTRACT
The authors discuss echocardiographic diagnosis and endovascular treatment of two different anatomical types of pulmonary arteriovenous fistula. Transoesophageal echocardiography in a cyanotic 3 year old boy revealed a direct right pulmonary artery left atrial fistula, treated by surgical ligation of the anomalous feeding artery. A cerebral abscess in a 22 year old man with hereditary haemorrhagic telangiectasia revealed pulmonary and cerebral arteriovenous malformations, which were both treated successfully by embolization. The value of echography is the demonstration of the right to left shunt at pulmonary level and, in some cases, the direct visualization of the arteriovenous malformation. Embolization should be considered as the therapeutic method of choice in all pulmonary arteriovenous fistula, except for direct pulmonary artery left atrial fistula.
Subject(s)
Arteriovenous Fistula/congenital , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Adult , Angiography , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/therapy , Child, Preschool , Echocardiography , Humans , Intracranial Arteriovenous Malformations/complications , Intracranial Arteriovenous Malformations/therapy , Male , Tomography, X-Ray ComputedABSTRACT
A 19-day-old child suffering from cyanosis due to tetralogy of Fallot was palliated by using his right retroesophageal subclavian artery. It was anastomosed side-to-side onto the ascending aorta and end-to-side onto the right pulmonary artery. The palliation obtained with this systemic-pulmonary shunt was satisfying. The right brachial vascular flow was normal.
