Surgical repairing of sternal defects with pentalogy of Cantrell

Abstract

Objective To summarize the diagnosis and treatment experience of 4 patients with Pentalogy of Cantrell (POC) and to evaluate the performance of artificial materials. Methods A retrospective analysis was performed for 4 hospitalized POC children from January 2010 to January 2017. The concurrent conditions included double outlet right ventricle (DORV, n=2), ventricular septal defect (VSD) & atrial septal defect (ASD) (n=1) and VSD & ASD & patent ductus arteriosus (PDA) (n=1). All cases were examined by cardiac ultrasound and reconstructed thoracoabdominal computed tomography (CT). Cardiac malformations were corrected according to ultrasonic findings. Titanium mesh was employed for repairing sternal and supraumbilical abdominal defects. Results All 4 patients underwent one-stage operations. And all hearts were repositioned eventually. Sternal and supraumbilical abdominal defects were revivified by titanium mesh. One double outlet right ventricle (DORV) had low cardiac output syndrome and pulmonary infection. Symptomatic treatment was offered until discharge. Exterior thorax was normal. The outcomes were excellent after a follow-up period of 3 months to 3 years. Conclusions The priority of surgical treatment for POC is to obtain satisfactory corrections of cardiac malformation. Operative difficulty decreases when titanium mesh is used for repairing sternal and supraumbilical abdominal defects. And exterior thorax may be ideally restored. Key words: Heart malformations; Diagnosis; Child; Pentalogy of Cantrell