Pulmonary atresia and ventricular septal defect: long-term results some type of preliminary palliative procedure

From 1999 to 2009, we have palliated 66 patients with pulmonary atresia and ventricular septal defect. They have been submitted to "rehabilitation" of the pulmonary arteries: group I (n = 38) received systemic-to-pul-monary shunt; group II (n = 28) underwent right ventricular outflow tract reconstruction without closure of the ventricular septal defect. The ages ranged from 3 days to 14 years. Initially, the size of the pulmonary arteries had no differences between groups (echocardiography, cardiac catheterization) (p >0.05). There were 11 hospital deaths (16.7%). Cardiac catheterization performed in all re-admitted patients revealed a twofold increase in the sizes of pulmonary arteries in group II (Nakata-index) (p = 0.003) and an increase of 1.3 times in the size of pulmonary arteries branches in group I (Redy-index) (p = 0.02). The results of right ventricular outflow tract reconstruction show that this procedure is more effective as an initial palliative procedure to facilitate the growth of hypoplastic main pulmonary arteries and to increase arterial oxygen saturation.