TY - JOUR
T1 - Innovation in Pulmonary Atresia Repair Using Right Atrial Appendage as Pulmonary Valve
T2 - A Case Report
AU - Ali, Waleed Shahzad
AU - Ali, Muhammad Zaid
AU - Rehman, Nohela
AU - Ur Rahman, Hafsah Alim
AU - Amanullah, Muneer
N1 - Publisher Copyright:
© 2025 College of Physicians and Surgeons Pakistan. All rights reserved.
PY - 2025/1
Y1 - 2025/1
N2 - A four-year girl with a ventricular septal defect (VSD) and pulmonary valve atresia (PVA) underwent a total correction surgery. Preoperative findings revealed a severe right-sided dilation, a right ventricular hypertrophy (RVH), a large conoventricular VSD, a slightly hypoplastic main pulmonary artery (MPA), and appropriately-sized pulmonary arteries. The surgery began with a midline sternotomy, patent ductus arteriosus (PDA) ligation, and initiation of cardiopulmonary bypass (CPB). The pericardium was harvested, and the right atrial appendage (RAA) was shaped into a bi-leaflet valve. A myomectomy was performed, and the VSD was closed with a continuous Dacron patch. Continuity between the right ventricular outflow tract (RVOT) and pulmonary artery (PA) was achieved using a transannular patch from autologous pericardium, and the RAA valve was implanted. A 15 mm Hegar dilator confirmed smooth blood flow. The patient showed satisfactory intraoperative transesophageal echocardiography (TEE) findings, including good ventricular function, an RVOT gradient of 20-25 mmHg, and no residual defects. The procedure achieved successful outcomes.
AB - A four-year girl with a ventricular septal defect (VSD) and pulmonary valve atresia (PVA) underwent a total correction surgery. Preoperative findings revealed a severe right-sided dilation, a right ventricular hypertrophy (RVH), a large conoventricular VSD, a slightly hypoplastic main pulmonary artery (MPA), and appropriately-sized pulmonary arteries. The surgery began with a midline sternotomy, patent ductus arteriosus (PDA) ligation, and initiation of cardiopulmonary bypass (CPB). The pericardium was harvested, and the right atrial appendage (RAA) was shaped into a bi-leaflet valve. A myomectomy was performed, and the VSD was closed with a continuous Dacron patch. Continuity between the right ventricular outflow tract (RVOT) and pulmonary artery (PA) was achieved using a transannular patch from autologous pericardium, and the RAA valve was implanted. A 15 mm Hegar dilator confirmed smooth blood flow. The patient showed satisfactory intraoperative transesophageal echocardiography (TEE) findings, including good ventricular function, an RVOT gradient of 20-25 mmHg, and no residual defects. The procedure achieved successful outcomes.
KW - Atrial appendage
KW - Cardiac surgery
KW - Congenital heart defect repair
KW - Pulmonary atresia
KW - Right ventricular outflow tract obstruction
KW - Tetralogy of Fallot
KW - Ventricular septal defect
UR - https://www.scopus.com/pages/publications/105018611551
U2 - 10.29271/jcpspcr.2025.377
DO - 10.29271/jcpspcr.2025.377
M3 - Article
AN - SCOPUS:105018611551
SN - 1022-386X
VL - 35
SP - 377
EP - 379
JO - Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
JF - Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
IS - 1
ER -