Complete Repair of Truncus Arteriosus and Interrupted Aortic Arch(Arch Reconstruction+Rastelli Operation)after Bilateral Pulmonary Artery Banding

(Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan)

Shuichi Shiraishi Masashi Takahashi Maya Watanabe
Yuka Okubo Masanori Tsuchida
A baby girl delivered at 41 weeks of gestation with persistent truncus arteriosus(PTA)and interrupted aortic arch(IAA)type A was referred to our institute for surgical intervention. Bilateral pulmonary artery banding(BPAB)proceeded through a median sternotomy at the age of 11 days to control excessive pulmonary blood flow. Thereafter, she gained weight under continuous prostaglandin E1(PGE 1)infusion. Definitive repair proceeded at the age of 2 months. Cardiopulmonary bypass was established through a redo-median sternotomy, with two arterial cannulae(brachiocephalic artery and descending aorta). The aortic arch was reconstructed with direct anastomosis. The orifice of the pulmonary artery was removed from the arterial trunk and the defect in the aortic wall was directly closed. A ventricular septal defect was closed under cardioplegic arrest via a right ventriculotomy. The continuity from the right ventricle to the pulmonary artery was made using a hand-made, extended polytetrafluoroethylene(ePTFE)conduit with a bicusp. The sternum was left open at the end of the procedure and the chest was closed on post-operative day(POD)3. She was weaned from mechanical ventilation on POD 4 and the postoperative course was uneventful. She was discharged on POD 49.
  Jpn. J. Cardiovasc. Surg. 42:442-446(2013)

Keywords:truncus arteriosus, interrupted aortic arch, pulmonary artery banding, staged operation