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Anomalous origin of pulmonary artery branch from aorta ascendens- Outcome of patients who underwent direct re-implantation
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  • Javid Raja,
  • Sabarinath Menon,
  • Arun Gopalakishnan,
  • Suneel P.R,
  • Baiju Dharan
Javid Raja
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Sabarinath Menon
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Arun Gopalakishnan
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Suneel P.R
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Baiju Dharan
Sree Chitra Tirunal Institute for Medical Sciences and Technology
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Abstract

Background: Anomalous origin of pulmonary artery branch from ascending aorta(AOPA) in the presence of two separate semilunar valves is a rare but important entity necessitating early diagnosis and surgery to prevent development of irreversible pulmonary vascular disease. We evaluated our experience with the technique and outcome of eleven patients with this condition. Methods: Between January 2000 and December 2018, eleven patients were diagnosed with AOPA. Echocardiographic data were collected from the records, regarding the site of origin of the anomalous pulmonary artery, additional defects, biventricular function and pulmonary artery pressures. Intraoperative charts were reviewed for the details of the surgical procedure and cardiopulmonary bypass. Postoperative data included survival, ventilatory support and duration of hospital stay. After discharge, children were reviewed at 1 month, 3 months, 6 months and then at yearly intervals. Results: Of the eleven patients, male to female ratio was 4:7 with a median age of six months(15 days - 28 years) and median weight of 5.7 kg(1.8 kg - 40 kg). Nine patients underwent direct re-implantation of anomalous pulmonary artery branch to main pulmonary artery. The survival rate was 91% in our series. On follow-up, no re-operations or re-interventions were required and all patients who underwent surgical correction were in stable clinical condition. Conclusion: Early and midterm outcomes of children who underwent surgery for AOPA is good. Early direct re-implantation of the anomalous branch PA to main pulmonary artery is the optimal surgical strategy for these patients