Simultaneous unifocalization of major aortopulmonary collateral and bidirectional Glenn shunt in a child with ventricular septal defect and pulmonary atresia. (September 2022)

• Record Type: Journal Article
• Authors: Singhi, Anil Kumar; Das, Mrinal Bandhu; Nath, Anish; Chatterjee, Dipanjan; Das, Soumen
• Is Part Of: Progress in pediatric cardiology. Volume 66(2022)
• Publication Date: 2022-09
• Subjects: Pulmonary atresia -- Ven septal defect -- Right pulmonary artery narrowing -- Aortopulmonary collateral -- Unifocalization -- Glenn shunt; Pediatric cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; Infant; Child; Cardiologie pédiatrique -- Périodiques; 618.9212005
• DOI: 10.1016/j.ppedcard.2022.101484
• Languages: English
• ISSNs: 1058-9813

Abstract

Abstract: Ventricular septal defect (VSD), pulmonary atresia and major aortopulmonary collateral (MAPCA) usually require staged intervention with an initial stage of unifocalization and aortopulmonary shunt. We report a 14 month young child weighing 6.7 kg having subaortic VSD, long segment pulmonary atresia, MAPCA with severe right pulmonary artery long segment narrowing undergoing simultaneous unifocalization of right MAPCA, bidirectional Glenn shunt, and patent ductus arteriosus ligation. Concomitant unifocalization along with Glenn shunt in resource-limited settings with challenging anatomy is safe and feasible in selected cases with a future plan of biventricular repair. Highlights: Ventricular septal defect, pulmonary atresia and major aortopulmonary collateral (MAPCA) is a heterogeneous disorder. Unifocalization of MAPCA and intracardiac repair with conduit or staged univentricular repair is the usual surgical approach. In selected cases, simultaneous unifocalization of MAPCA along with Glenn shunt is a feasible option in resource limited settings pending future biventricular repair.