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Effectiveness of posterior aortopexy for the left pulmonary vein obstruction between the left atrium and the descending aorta
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  • Kwang Ho Choi,
  • Hyungtae Kim,
  • Si Chan Sung,
  • Hyoung Doo Lee,
  • Hoon Ko,
  • Joung-Hee Byun
Kwang Ho Choi
Pusan National University Yangsan Hospital
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Hyungtae Kim
Pusan National University Yangsan Hospital
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Si Chan Sung
Pusan National University Yangsan Hospital
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Hyoung Doo Lee
Pusan National University Yangsan Hospital
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Hoon Ko
Pusan National University Yangsan Hospital
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Joung-Hee Byun
Pusan National University Yangsan Hospital
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Abstract

Background: Left pulmonary vein (PV) obstruction can occur due to compression between the left atrium (LA) and the descending aorta (DA). One of the effective solutions for this problem is posterior aortopexy. In this study, we have reported five cases of posterior aortopexy to relieve left PV obstruction between the LA and the DA. Methods: Since August 2012, five patients have undergone posterior aortopexy for compression of the left PV between the LA and the DA. The median age and weight of the patients at the time of operation were 5.5 months (range, 1-131 months) and 5.2 kg (range, 4.2-29.5 kg), respectively. The left PV obstruction was initially diagnosed on echocardiography in four patients and computed tomography angiography in one patient. The median peak pressure gradient across the obstructed left PV was 7.3 mmHg (range, 4-20 mmHg). Concomitant procedures were ventricular septal defect closure in one patient and patent ductus arteriosus ligation in one patient. Results: There was no PV obstruction on echocardiography in any of the patients after the operation except in the case of one patient who had diffuse pulmonary vein stenosis. The median follow-up duration was 34 months (range, 14-89 months), and during follow-up no incidence of the left PV obstruction was observed in any of the surviving patients. Conclusions: The posterior aortopexy technique could be a good surgical option for the left PV obstruction caused by compression between the LA and the anteriorly positioned DA.

Peer review status:ACCEPTED

23 Mar 2021Submitted to Journal of Cardiac Surgery
23 Mar 2021Assigned to Editor
23 Mar 2021Submission Checks Completed
18 Apr 2021Review(s) Completed, Editorial Evaluation Pending
19 Apr 2021Editorial Decision: Accept