Surgical treatment of patent ductus arteriosus dependent pulmonary atresia with ventricular septal defect

Abstract

Objective To investigate surgical approaches and compare the clinical outcomes of patent ductus arteriosus(PDA) dependent pulmonary atresia with ventricular septal defect(PA/VSD) in different anatomical classifications. Methods To retrospectively analyze the clinical data of 99 PA/VSD cases from January 2005 to December 2014 in Guangdong Cardiovascular Institute. Pulmonary blood flow was mainly supplied by PDA in these patients of this study, which fell into the category of typeⅠorⅡof PA/VSD according to anatomical classifications. 36 females and 63 males were included in our study, with median age of 8.2 months(0.4 to 291.9 months), and median weight of 6.5 kg(2.3 to 50.0 kg), respectively. Of these patients, 61 cases and 38 cases were categorized as type Ⅰ and type Ⅱ of PA/VSD, in which 36 patients and 63 patients underwent staged procedure or curative correction, respectively. Results There was statistical significance between typeⅠand typeⅡof PA/VSD patients in cardiopulmonary bypass duration, aortic cross-clamp time, preoperative oxygen saturation, surgical methods of PDA, and surgical approaches of right ventricular outflow tract(RVOT) reconstruction. In addition, there was also statistical significance between staged procedure and curative correction in cardiopulmonary bypass duration, aortic cross-clamp time, minimal temperature in cardiopulmonary bypass, preoperative and postoperative oxygen saturation, and surgical methods of PDA. Conclusion The short-term outcome of surgical treatment of PDA dependent PA/VSD is satisfactory. There are differences in surgical approaches and early effectiveness based on various different anatomical classifications, and therefore, individualized evaluation is required. Key words: Pulmonary atresia; Ventricular septal defect; Cardiac surgical procedures