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J Thorac Cardiovasc Surg 2006;132:444
© 2006 The American Association for Thoracic Surgery

Letter to the Editor

Is there any difference between surgical outflow reconstruction and transcatheter valvotomy in patients with pulmonary atresia with intact ventricular septum?

Department of Pediatric Cardiology, Istituto Policlinico San Donato Milanese, Milan, Italy

To the Editor:

I read with great interest the article by Daubeney and associates ¹ for the UK and Ireland Collaborative Study of Pulmonary Atresia with Intact Ventricular Septum. This is an ongoing population study comprising 183 patients. The authors report that independent risk factors for death were low birth weight, unipartite right ventricular morphology, and the presence of a dilated ventricle.

The primary procedure comprised a systemic-pulmonary shunt in 81 patients, percutaneous transcatheter valvotomy in 40 patients, surgical outflow reconstruction alone in 27 patients, and surgical outflow reconstruction with a concomitant shunt in another 18 patients.

I would like to ask some questions about patients who received surgical outflow reconstruction and the group of subjects who underwent a percutaneous approach:

1 Was there any difference in terms of survival between the two groups?

2 How many subjects treated with a percutaneous approach needed a systemic-pulmonary shunt after the transcatheter procedure?

3 Was there any difference between the two groups in terms of right ventricular morphology and/or tricuspid valvular z score?

4 Was there any difference in terms of the achievement of type of repair (biventricular, univentricular, mixed, or one-and-a-half ventricular)?

In fact, there is no agreement about the best approach to use to open the right ventricular outflow tract in subjects who have the membranous type of pulmonary atresia with intact ventricular septum with a tripartite or bipartite right ventricle. Finally, no comparative studies exist.

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1. Daubeney PEF, Wang D, Delany DJ, Keeton BR, Anderson RH, Slavik Z, et al. UK and Ireland Collaborative Study of Pulmonary Atresia with Intact Ventricular Septum. J Thorac Cardiovasc Surg 2005;130:1071-1078.[Abstract/Free Full Text]
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Butera, G. Search for Related Content PubMed PubMed Citation Articles by Butera, G. Related Collections Congenital - cyanotic Related Articles