Objective: To report our experience on treating congenital aortic arch disease using autologous pulmonary artery patch are reported here.
Method: From Apr. 1993 to Oct. 2008, 23 patients with congenital aortic arch disease received one-stage complete correction using autologous pulmonary artery patch, including 15 male and 8 female aged from 6 weeks to 6.5 years old (10.6±25.3months) There were 5 CoA, 5 IAA and 13 hypoplasia of aortic arch. Concomitant anomalies included VSD in 16, ASD in 6, aortic stenosis in 1, LVOT obstruction in 3 and dextracardia in 1. There were 7 patients with moderate and 16 with severe pulmonary hypertension. The operation was performed with DHCA, CPB and selective cerebral perfusion. The anterior wall of main pulmonary artery was excised to reconstruct the aortic arch. Then the main pulmonary artery was reconstructed by direct suture (18) or autologous pericardium plasty(5). Other cardiac anomalies were corrected concomitantly.
Results: All patients had uneventful surgery. There was 1 in-hospital death (5.9%), no brain injury. Postoperative echocardiography and CT study showed intracardiac anomalies corrected without residual stenosis. 22 patients have been doing well during a follow up period of 2 months to 16 years. No aortic or subaortic stenosis found.
Conclusion: One-stage complete correction can be achieved with good result in congenital aortic disease associated with other cardiac anomalies. With the benefit of growth potential and less tension, autologous pulmonary artery tissue is an optimal choice in aortic arch reconstruction.