Surgical indication for congenital heart disease with extremely thickened media of small pulmonary arteries Shigeo Yamaki, MD, Ai Abe, MD, Masato Endo,

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Presentation transcript:

Surgical indication for congenital heart disease with extremely thickened media of small pulmonary arteries Shigeo Yamaki, MD, Ai Abe, MD, Masato Endo, MD, Takashi Tanaka, MD, Koichi Tabayashi, MD, Tohru Takahashi, MD The Annals of Thoracic Surgery Volume 66, Issue 5, Pages 1560-1564 (November 1998) DOI: 10.1016/S0003-4975(98)00776-0

Fig 1 A diagnosis of extremely thickened media of small pulmonary arteries was made when there were small pulmonary arteries in which the percentage wall thickness was 33% or greater, ie, when a + b ≥ 2c. The Annals of Thoracic Surgery 1998 66, 1560-1564DOI: (10.1016/S0003-4975(98)00776-0)

Fig 2 Case 8. Small pulmonary arteries with extremely thickened media from a patient who died 10 months after pulmonary artery banding. Each small artery has an extremely thickened media, and the luminal space is small, leaving room for only a few red blood cells (RBC) to pass through. The Annals of Thoracic Surgery 1998 66, 1560-1564DOI: (10.1016/S0003-4975(98)00776-0)

Fig 3 Case 10. The small pulmonary arteries show strongly hypertrophic media 4 months after operative repair. (RBC = red blood cells.) The Annals of Thoracic Surgery 1998 66, 1560-1564DOI: (10.1016/S0003-4975(98)00776-0)

Fig 4 Comparison of cardiac catheterization in the operative survivors versus deceased patients. Asterisks indicate late deaths. (PAMP = pulmonary arterial mean pressure; PASP = pulmonary arterial systolic pressure; PVR = pulmonary vascular resistance.) The Annals of Thoracic Surgery 1998 66, 1560-1564DOI: (10.1016/S0003-4975(98)00776-0)

Fig 5 The numerical percentage of small pulmonary arteries with percent wall thickness greater than 33% (percentage of thickened arteries) in 19 cases. Asterisks indicate cases in which pulmonary arterial pressure did not decrease. The Annals of Thoracic Surgery 1998 66, 1560-1564DOI: (10.1016/S0003-4975(98)00776-0)