HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ilbawi, M. N. Articles by Paul, M. H. Search for Related Content PubMed PubMed Citation Articles by Ilbawi, M. N. Articles by Paul, M. H.

The Journal of Thoracic and Cardiovascular Surgery, Vol 91, 584-589, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Surgical approach to severely symptomatic newborn infants with tetralogy of Fallot and absent pulmonary valve

MN Ilbawi, J Fedorchik, AJ Muster, FS Idriss, SY DeLeon, SS Gidding and MH Paul

The surgical management of severely symptomatic newborn infants with tetralogy of Fallot and absent pulmonary valve has been controversial, and the results of a variety of operative approaches have not been satisfactory. We report on a technique for the treatment of these patients, which consists of (1) ligation of the main pulmonary artery to eliminate pulmonary regurgitation, excessive right ventricular stroke output, and secondary pulmonary artery dilation and airway obstruction and (2) insertion of a subclavian-pulmonary artery polytetrafluoroethylene shunt to provide pulmonary blood flow. The procedure was used in four neonates. Two patients operated on at 2 and 3 days of age are doing well 15 and 19 months postoperatively. The other two, operated on at 3 and 4 weeks of age after unsuccessful prolonged medical treatment and positive-pressure ventilation, failed to show long-term improvement and died of sepsis and respiratory failure 3 and 5 months after operation. This experience, though limited, suggests that early surgical intervention to control pulmonary regurgitation prevents progressive pulmonary artery dilatation and secondary bronchial compression, decreases the need for prolonged preoperative and postoperative ventilation, and improves the outcome of these critically ill neonates.

This article has been cited by other articles:

				J. W. Brown, M. Ruzmetov, P. Vijay, M. D. Rodefeld, and M. W. Turrentine Surgical Treatment of Absent Pulmonary Valve Syndrome Associated With Bronchial Obstruction Ann. Thorac. Surg., December 1, 2006; 82(6): 2221 - 2226. [Abstract] [Full Text] [PDF]

				S. Attanawanich, P. Khowsathit, and W. Withurawanit Correction of Absent Pulmonary Valve Syndrome Using a Pericardial Valved Conduit Asian Cardiovasc Thorac Ann, September 1, 2002; 10(3): 270 - 272. [Abstract] [Full Text] [PDF]

				C. C. Hew, S. H. Daebritz, D. Zurakowski, P. I. del Nido, J. E. Mayer Jr, and R. A. Jonas Valved homograft replacement of aneurysmal pulmonary arteries for severely symptomatic absent pulmonary valve syndrome Ann. Thorac. Surg., June 1, 2002; 73(6): 1778 - 1785. [Abstract] [Full Text] [PDF]

				Z. Al-Halees, M. Ahmad, O. Galal, F. Godart, and C. Planche Tetralogy of Fallot With Absent Pulmonary Valve: In Praise of Two-Stage Repair Ann. Thorac. Surg., April 1, 1997; 63(4): 1216 - 1217. [Full Text]

				F. Godart, L. Houyel, F. Lacour-Gayet, A. Serraf, M. Sousa-Uva, J. Bruniaux, J. Petit, J.-D. Piot, J.-P. Binet, S. Conte, et al. Absent Pulmonary Valve Syndrome: Surgical Treatment and Considerations Ann. Thorac. Surg., July 1, 1996; 62(1): 136 - 142. [Abstract] [Full Text]

				J. A. M. van Son and F. W. Mohr MEDIAN STERNOTOMY FOR PROLONGED RESUSCITATION IN NEONATAL TETRALOGY OF FALLOT WITH ABSENT PULMONARY VALVE J. Thorac. Cardiovasc. Surg., July 1, 1996; 112(1): 185 - 186. [Full Text]