A Successful Case of Sutureless Pulmonary Artery Plasty Using Autologous Tissue for Severe Pulmonary Stenosis after a Rastelli Operation

Masahiro Yoshida Masaaki Yamagishi Yoshiaki Yamada
Katsuji Fujiwara Jun Fukumoto Keisuke Shunto
Nobuo Kitamura

(The Department of Cardiovascular Surgery, Children's Research Hospital, Kyoto, Japan)

An 11-year-old boy, who underwent a Rastelli operation using a 14mm artificial graft and left pulmonary artery (PA) plasty with an autologous pericardium patch 7 years previously, had severe recurrent left pulmonary stenosis. Reoperation was performed including right ventricular outflow tract reconstruction and left PA plasty. The PA at the most stenotic site was only 2mm in diameter; it was enlarged to 10mm by good exposure and an incision on the pulmonary intima. A bovine pericardium patch with a handmade ePTFE valve was sutured onto the autologous tissue not onto the pulmonary intima to avoid restenosis and in expectation of the growth of the pulmonary orifice. On postoperative 3-D CT, the left pulmonary artery was patent and 9mm in diameter. Pulmonary scintigraphy showed an improvement in the left pulmonary perfusion. This sutureless technique was useful in this case of severe pulmonary stenosis.
 Jpn. J. Cardiovasc. Surg. 31: 236-238 (2002)