Abstract
Background. The left atrial appendage (LAA) may serve as an alternative to the pulmonary arterial wall for right ventricular outflow tract (RVOT) reconstruction without an extracardiac conduit. Methods. Five consecutive patients with pulmonary atresia or severe stenosis underwent corrective (n = 4) or palliative (n = 1) RVOT reconstruction using an LAA insertion. Surgery was performed to treat tetralogy of Fallot, double-outlet right ventricle, or transposition of the great arteries. By inserting the LAA into the obstructed portion, the width of the posterior wall of the RVOT was 20 mm or more. The anterior half of the RVOT was then augmented with pericardial patch. Results. There were no early or late postoperative deaths, and no major complications (arrhythmias, thrombo-embolic episodes, infective endocarditis, need for reoperation). The postrepair systolic right ventricularto-systemic arterial pressure ratio was 0.61 ± 0.26. Color Doppler flow mapping revealed that the reconstructed RVOT was nonobstructive and had nonturbulent flow. No thrombus or pseudoneointimal formation was observed in the RVOT. Conclusions. LAA insertion in the RVOT is an effective alternative to, or adjunct of, direct anastomosis. It offers several advantages, including fewer early and midterm complications and avoiding the use of an extracardiac conduit.
| Original language | English |
|---|---|
| Pages (from-to) | 501-505 |
| Number of pages | 5 |
| Journal | Annals of Thoracic Surgery |
| Volume | 71 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2001 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
Left atrial appendage insertion for right ventricular outflow tract reconstruction. / Aeba, Ryo; Katogi, Toshiyuki; Kashima, Ichiro; Moro, Katsumi; Ito, Tsutomu; Kawada, Shiaki; Takahashi, Etsuro.
In: Annals of Thoracic Surgery, Vol. 71, No. 2, 2001, p. 501-505.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Left atrial appendage insertion for right ventricular outflow tract reconstruction
AU - Aeba, Ryo
AU - Katogi, Toshiyuki
AU - Kashima, Ichiro
AU - Moro, Katsumi
AU - Ito, Tsutomu
AU - Kawada, Shiaki
AU - Takahashi, Etsuro
PY - 2001
Y1 - 2001
N2 - Background. The left atrial appendage (LAA) may serve as an alternative to the pulmonary arterial wall for right ventricular outflow tract (RVOT) reconstruction without an extracardiac conduit. Methods. Five consecutive patients with pulmonary atresia or severe stenosis underwent corrective (n = 4) or palliative (n = 1) RVOT reconstruction using an LAA insertion. Surgery was performed to treat tetralogy of Fallot, double-outlet right ventricle, or transposition of the great arteries. By inserting the LAA into the obstructed portion, the width of the posterior wall of the RVOT was 20 mm or more. The anterior half of the RVOT was then augmented with pericardial patch. Results. There were no early or late postoperative deaths, and no major complications (arrhythmias, thrombo-embolic episodes, infective endocarditis, need for reoperation). The postrepair systolic right ventricularto-systemic arterial pressure ratio was 0.61 ± 0.26. Color Doppler flow mapping revealed that the reconstructed RVOT was nonobstructive and had nonturbulent flow. No thrombus or pseudoneointimal formation was observed in the RVOT. Conclusions. LAA insertion in the RVOT is an effective alternative to, or adjunct of, direct anastomosis. It offers several advantages, including fewer early and midterm complications and avoiding the use of an extracardiac conduit.
AB - Background. The left atrial appendage (LAA) may serve as an alternative to the pulmonary arterial wall for right ventricular outflow tract (RVOT) reconstruction without an extracardiac conduit. Methods. Five consecutive patients with pulmonary atresia or severe stenosis underwent corrective (n = 4) or palliative (n = 1) RVOT reconstruction using an LAA insertion. Surgery was performed to treat tetralogy of Fallot, double-outlet right ventricle, or transposition of the great arteries. By inserting the LAA into the obstructed portion, the width of the posterior wall of the RVOT was 20 mm or more. The anterior half of the RVOT was then augmented with pericardial patch. Results. There were no early or late postoperative deaths, and no major complications (arrhythmias, thrombo-embolic episodes, infective endocarditis, need for reoperation). The postrepair systolic right ventricularto-systemic arterial pressure ratio was 0.61 ± 0.26. Color Doppler flow mapping revealed that the reconstructed RVOT was nonobstructive and had nonturbulent flow. No thrombus or pseudoneointimal formation was observed in the RVOT. Conclusions. LAA insertion in the RVOT is an effective alternative to, or adjunct of, direct anastomosis. It offers several advantages, including fewer early and midterm complications and avoiding the use of an extracardiac conduit.
UR - http://www.scopus.com/inward/record.url?scp=0035117279&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035117279&partnerID=8YFLogxK
U2 - 10.1016/S0003-4975(00)02037-3
DO - 10.1016/S0003-4975(00)02037-3
M3 - Article
C2 - 11235697
AN - SCOPUS:0035117279
VL - 71
SP - 501
EP - 505
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 2
ER -