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| A Successful Case of Sutureless
Pulmonary Artery Plasty Using Autologous Tissue for Severe Pulmonary
Stenosis after a Rastelli Operation |
| Masahiro Yoshida |
Masaaki Yamagishi |
Yoshiaki Yamada |
| Katsuji Fujiwara |
Jun Fukumoto |
Keisuke Shunto |
| Nobuo Kitamura |
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(The Department of Cardiovascular Surgery, Children's
Research Hospital, Kyoto, Japan)
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An 11-year-old boy, who underwent a Rastelli operation using
a 14mm artificial graft and left pulmonary artery (PA) plasty
with an autologous pericardium patch 7 years previously, had
severe recurrent left pulmonary stenosis. Reoperation was performed
including right ventricular outflow tract reconstruction and
left PA plasty. The PA at the most stenotic site was only 2mm
in diameter; it was enlarged to 10mm by good exposure and an
incision on the pulmonary intima. A bovine pericardium patch
with a handmade ePTFE valve was sutured onto the autologous tissue
not onto the pulmonary intima to avoid restenosis and in expectation
of the growth of the pulmonary orifice. On postoperative 3-D
CT, the left pulmonary artery was patent and 9mm in diameter.
Pulmonary scintigraphy showed an improvement in the left pulmonary
perfusion. This sutureless technique was useful in this case
of severe pulmonary stenosis.
Jpn. J. Cardiovasc. Surg. 31: 236-238 (2002) |
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