Primary Central Pulmonary Artery Plasty for Single Ventricle With Ductal-Associated Pulmonary Artery Coarctation Kisaburo Sakamoto, MD, Noritaka Ota,

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Primary Central Pulmonary Artery Plasty for Single Ventricle With Ductal-Associated Pulmonary Artery Coarctation Kisaburo Sakamoto, MD, Noritaka Ota, MD, Yoshifumi Fujimoto, MD, Masaya Murata, MD, Yujiro Ide, MD, Maiko Tachi, MD, Hiroki Ito, MD, Kazuyoshi Kanno, MD, Hironaga Ogawa, MD, Tomoyuki Fujita, MD, PhD The Annals of Thoracic Surgery Volume 98, Issue 3, Pages 919-926 (September 2014) DOI: 10.1016/j.athoracsur.2014.05.005 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Operative techniques of primary central pulmonary artery (PA). (A) Primary central PA plasty with modified Blalock-Taussig shunt is performed on pump in beating-heart state, with patent ductus arteriosus division; the pulmonary artery flap is created along the dotted line (arrows). (B) Frontal view of central pulmonary artery; after the creation of the PA flap, all ductal tissue is excised along dotted line. (C) The posterior wall of the central PA is anastomosed using 8-0 polypropylene continuous sutures. (D) The anterior aspect of the anastomosis is achieved with an interrupted suture technique using 8-0 polypropylene sutures. The Annals of Thoracic Surgery 2014 98, 919-926DOI: (10.1016/j.athoracsur.2014.05.005) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Angiogram before the initial palliative operation. (B) Angiogram before bidirectional cavopulmonary connection. The numbers show the diameter of pulmonary artery on each sites (arrows). The Annals of Thoracic Surgery 2014 98, 919-926DOI: (10.1016/j.athoracsur.2014.05.005) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Patient status in this cohort. The Annals of Thoracic Surgery 2014 98, 919-926DOI: (10.1016/j.athoracsur.2014.05.005) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) The pulmonary artery (PA) diameter ratio is the nonshunt side PA diameter divided by the shunt side PA diameter. (B) The PA diameter differential ratio (%) is (1 − [smaller PA/larger PA] × 100). The Annals of Thoracic Surgery 2014 98, 919-926DOI: (10.1016/j.athoracsur.2014.05.005) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions