Early Single-Stage Surgical Revascularization of Pulmonary Artery in Unilateral Absence of a Pulmonary Artery

Abstract BackgroundThis research aims to summarize the findings of the early single-stage revascularization of remnant pulmonary artery in unilateral absent intrapericardial pulmonary artery. MethodsWe retrospectively analyzed the medical records of 10 patients with unilateral absent pulmonary artery, in which 7 were right and 3 were left, the median age and median weight at surgery was 4 months and 5.2 kg, respectively. The patients received operation from January 2009 to June 2020. ResultsTen patients, 1 case associated with atrial septal defect, 2 cases with tetralogy of Fallot, and 1 case with aortopulmonary window. The median diameter of the affected hilar pulmonary artery remnants was 3.1mm (1.6-5mm), and the Z value was -3.66±1.86 (range, -6.7 to -1.75). All the patients received single-stage revascularization: tube graft interposition in 3 patients, autologous pericardial roll in 4, direct anastomosis in one, and main pulmonary artery flap angioplasty in the rest 3. No hospital deaths occurred. The follow-up period was 1 month to 5.6 years. One case underwent percutaneous balloon dilatation due to new pulmonary artery stenosis. Nonetheless, the results were encouraging, symptoms have improved in all patients. The Z value of the latest ipsilateral pulmonary artery diameter was -2.34±1.18 (range, -4.52 to -1.35), a significantly improvement when compared to the preoperative value.ConclusionsSingle-stage pulmonary artery revascularization is effective at restoring normal antegrade flow to the affected lung, resulting in improved diameter of the PA, and patient’s symptoms. However, transcatheter intervention may diminish the new pulmonary artery stenosis temporarily, reoperation is still needed in the long-term follow-up.