Unilateral Absence Of A Pulmonary Artery Research Articles

Surgical treatment for tetralogy of Fallot with unilateral absence of a pulmonary artery (author's transl)

Among 843 patients with Tetralogy of Fallot, 10 showed unilateral absence of a pulmonary artery. In 7 cases the cause was congenital aplasia, whereas thrombosis of one of the pulmonary arteries following systemic-pulmonary anastomosis was the cause in the remaining 3 patients. According to the reports of other authors and to our own experiences, this rare malformation is treated best with palliative operations, the technique depending on the patient's age and on the individual anatomical condition. Only in very few cases with an acceptable pathologic anatomy there will be a reasonable chance for successful repair with reconstruction of the continuity from the right ventricle to the affected lung. However, if complete repair is performed, reconstruction of the absent pulmonary artery usually will be necessary for avoidance of pulmonary hypertension of the contralateral lung.

Absence of anatomic origin from heart of pulmonary arterial supply: Clinical application of classification

A group of 262 patients with discontinuity between the heart and the pulmonary arterial supply was reviewed with respect to the anatomic variants. Of the 262 patients, 167 (64 per cent) had confluence of the right and left pulmonary arteries, and only 9 (3 per cent) had nonconfluence. Sixty-two patients (24 per cent) had no pulmonary arteries, and 24 patients (9 per cent) had unilateral absence of a pulmonary artery (mixed type). The review indicates that the classification is practical when applied to a large clinical experience since it distinctly categorizes individual patients, differentiates those who are operable from those presently inoperable, and conforms to the technical considerations for repair in operable cases.

Surgical Treatment of Tetralogy of Fallot with Unilateral Absence of a Pulmonary Artery

Tetralogy of Fallot with unilateral absence of a pulmonary artery imposes more marked symptomatology and a much shorter life-span in comparison with the usual tetralogy of Fallot. The operative mortality with total correction has been 50%, and the survivors require prolonged hospitalization for control of severe right heart failure. An aorta-to-right pulmonary artery shunt is suggested as a satisfactory palliative measure which may have beneficial effects on the pulmonary vascular bed, permitting a safer total correction at a later date.

Congenital unilateral absence of a pulmonary artery.

SummaryTwo cases of isolated unilateral absence of a pulmonary artery and one case of unilateral hypoplasia of a pulmonary artery are reported. The embryology, clinical features and radiological findings are discussed. In particular, the importance of the plain chest radiograph in the diagnosis is stressed. The interesting finding, on barium swallow, of pseudodiverticula of the oesophagus due to extrinsic pressure produced by anastomotic vessels is described for the first time.

Effects of mild chronic hypoxia on the pulmonary circulation in calves with reactive pulmonary hypertension.

The effects of the mild hypoxia at an altitude of 5280 ft on the pulmonary circulation were examined in normal calves and calves with a preexisting stimulus to maintain a reactive pulmonary vascular bed. In a serial study, 9 calves born at 5280 ft and 9 calves born at sea level underwent left pulmonary artery (LPA) ligation; 3 calves born at 5280 ft and 8 calves born at sea level underwent right pulmonary artery (RPA) ligation within 24 to 48 hours after birth. Progressive pulmonary hypertension and right ventricular heart failure developed in all calves operated on at 5280 ft but not in those with LPA ligation performed at sea level until they were transferred to 5280 ft. In contrast, in some animals with RPA ligation at sea level, progressive pulmonary hypertension was noted. The increased pulmonary blood flow consequent to LPA ligation does not result in progressive pulmonary hypertension at sea level but the addition of the mild hypoxia at 5280 ft appears to provide additional sufficient stimulus to result in progressive pulmonary hypertension. However, the slightly higher pulmonary blood flow subsequent to RPA ligation is capable of producing progressive pulmonary hypertension at sea level. Correlation was found between these results and human patients with congenital unilateral absence of a pulmonary artery, indicating that, in subjects with some stimulus to maintain a reactive pulmonary vascular bed, the mild hypoxia of 5280 ft may exert a significant effect on the pulmonary circulation.

Congenital unilateral absence of a pulmonary artery: A report of three cases ∗

Three cases of unilateral absence of a primary division of the pulmonary trunk have been presented. Clinical recognition of this anomaly is afforded by including it in the differential diagnosis in patients with pulmonary hypertension and cyanotic congenital heart disease, and by considering it in patients whose roentgenograms demonstrate comparative differences in vascularity of their lung fields and disparity in size of the two hemithoraxes. Confirmation is often obtained by angiocardiographic examination.