Bilateral Unifocalization For Ventricular Septal Defect And Pulmonary Atresia With Major Aortopulmonary Collateral Arteries

Emin TİRELİ, Cevahir HABERAL, Kubilay KORKUT, Enver DAYIOĞLU, Ertan ONURSAL, *Yılmaz NİŞANCI

İstanbul Üniversitesi Tıp Fakültesi, İstanbul, Göğüs, Kalp ve Damar Cerrahisi Anabilim Dalı,
^*Kardioloji Anabilim Dalı

Patents with Ventricular Septal Defect (VSD) and pulmonary atresia with major aortopulmonary collateral arteries (MAPCAs) are not appopriate for one stage repair, because they have hypoplastic pulmonary arteries (PAs) and major arborization defects in their lungs. Patient without hypoplastic PAs and arborization defects are suitable for one stage total correction. However if they have hypoplastic PAs, the approach should be a shunt operation at first stage before the total correction procedure. Many authors have reported studies about unifocalization as the first stage operation and the correction by replacement of a conduit between right ventricle and PAs as the second stage.

If direct anastomosis of MAPCAs with central PAs is difficult technically, interposition grafts should be used. In our 17 year old patient we have unifocalised MAPCAs with left and right PA's using polytetraflouroethylene (PTFE) tube grafts through median sternotomy. With this case, we want to report that performing bilateral unifocalization operation through median sternotomy is practicable.

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