Choice of Palliative Procedures for Pulmonary Atresia With Ventricular Septal Defect Patients

Femoral Allogenic Vein Valved Conduit for Palliative Repair of Pulmonary Atresia With Ventricular Septal Defect

The aim is to compare effective growth true hypoplastic pulmonary arteries using Right Ventricle Outflow Tract Reconstruction by femoral allogenic vein valve conduit and systemic-to-pulmonary artery shunts (modified Blalock-Taussig shunt)

The use of femoral allogenic vein valve conduit for Right Ventricle Outflow Tract Reconstruction is good alternative systemic-to-pulmonary artery shunts (modified Blalock-Taussig shunt). Main advantages is straight, symmetrical, pulsating, systolic blood flow in hypoplastic pulmonary artery, which stimulate growth and prepares for a radical repair. Taking into account the absence randomized studies in this area of medicine, providing investigation evaluating parameters of safety for both methodics is very actual.

Inclusion criteria

Patients who met the following criteria were included:

• Patients with PA-VSD type A and B (by Tchervenkov) scheduled for palliative surgery
• Age less than one year
• Confluent pulmonary artery
• Nakata Index ≤ 120 mm2/m2. Exclusion criteria

Patients who met any of the following criteria were excluded:

• Discordant atrioventricular and/or discordant ventriculo-arterial connections
• Concomitant pathology (pneumonia, brain damage, or enterocolitis)
• Genetic syndromes (DiGeorge, Alagille, VACTER, CHARGE)
• Scheduled MAPCA unifocalisation
• Anomalous coronary arteries
• Other surgical approaches (complete primary repair, primary unification of pulmonary blood flow, stenting RVOT, or patent ductus arteriosus, radiofrequency pulmonary valve perforation).