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Staged repair of tetralogy of Fallot with pulmonary atresia and major aortopulmonary collateral arteries  Brian W Duncan, MD, Roger B.B Mee, MB, CHB,

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Presentation on theme: "Staged repair of tetralogy of Fallot with pulmonary atresia and major aortopulmonary collateral arteries  Brian W Duncan, MD, Roger B.B Mee, MB, CHB,"— Presentation transcript:

1 Staged repair of tetralogy of Fallot with pulmonary atresia and major aortopulmonary collateral arteries  Brian W Duncan, MD, Roger B.B Mee, MB, CHB, FRACS, Lourdes R Prieto, MD, Geoffrey L Rosenthal, MD, PhD, C.Igor Mesia, MD, Athar Qureshi, MD, Om P Tucker, MD, John F Rhodes, MD, Larry A Latson, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 126, Issue 3, Pages (September 2003) DOI: /S (03)

2 Figure 1 Paradigm for selective, staged treatment of TOF-PA with diminutive confluent central pulmonary arteries. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

3 Figure 2 Paradigm for selective, staged treatment of TOF-PA with small confluent central pulmonary arteries. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

4 Figure 3 Melbourne shunt: side-biting clamp controls the ascending aorta; soft clamps control the branch pulmonary arteries. Inset demonstrates the completed shunt with the pulmonary artery anastomosed to the posterior and left lateral aspect of the ascending aorta close to the sinotubular junction. Reprinted with the permission of The Cleveland Clinic Foundation. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

5 Figure 4 Paradigm for selective, staged treatment of TOF-PA with absent central pulmonary arteries. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

6 Figure 5 Number of operative procedures for patients ultimately undergoing complete repair. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

7 Figure 6 Outcomes for patients with TOF-PA treated with selective, staged surgical protocol. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

8 Figure 7 Intraoperative mean pulmonary artery pressure to mean systemic blood pressure ratios (MPAP/MSBP) and latest right ventricular pressure to systemic systolic blood pressure ratios (RVP/SBP) for patients undergoing complete repair (both ratios available for 22 patients). Filled diamonds, patients who remain with closed VSD; clear diamonds, patients who have undergone VSD fenestration after VSD closure (n = 2). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /S (03) )

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