Eugen Sandica
Heart and Diabetes Centre NRW, Germany
Title: Unifocalization in patients with single – and two-ventricle physiology
Biography
Biography: Eugen Sandica
Abstract
Obiective. This retrospective study reviews our results with unifocalization of major aortopulmonary collateral arteries (MAPCAS) in patients with single- and two-ventricle physiology.
Method. 13 patients (median weight 7.8 kg, median age 12 months) with pulmonary atresia and MAPCAS have been operated on between October 2008 and August 2014. Two patients had already had a shunt procedure, in one of them together with correction of a total anomalous pulmonary venous connection. Three patients had a functional single ventricle. In all patients a midline one-stage complete unifocalization of the MAPCA has been performed together with a shunt as a pulmonary blood flow source in three patients, a Glenn procedure in two patients and an intra-cardiac repair (closure of the ventricular septal defect) with right (RV) ventricle to pulmonary artery valves conduit in eight patients.
Results. All patients survived the unifocalization procedure and are alive at a mean follow-up of 40.6 months (range 1 – 70 months). Two patients with single-ventricle physiology already received the Fontan palliation with a non-fenestrated extra cardiac conduit. Three patients with two-ventricle physiology needed catheter interventions for peripheral pulmonary artery stenosis and eventually stent implantation in two cases. Two patients with unifocalization and intracardiac repair had an RV pressure estimate on their latest echo using the tricuspid regurgitation envelope of one half systemic pressure while another two patients had an RV pressure estimate of more than two thirds systemic pressure.
Conclusions. In our experience very good results can be obtained after unifocalization in patients with single- and two-ventricle physiology.