A Modern Approach to the Treatment of Pulmonary Artery Atresia with Ventricular Septal Defect and Large Aortopulmonary Collateral Arteries

Abstract

Pulmonary artery atresia with interventricular septal defect (ALA with DMF) and collateral pulmonary blood flow is a severe heart defect in which the choice of surgical treatment tactics is a difficult task. According to some authors, this defect occurs in 5-7% of all cases of pulmonary artery atresia with ventricular septal defect (ALA with DMJP) [1, 2, 4]. A distinctive feature of the defect is the multifocal nature of the pulmonary blood supply, which involves both the pulmonary arteries and large aortolegic collaterals extending from the aorta or its branches [3, 5, 8]. The complexity of the defect is reflected in the variety of existing surgical treatment methods, among which both staged operations and simultaneous radical correction are presented. Although radical correction is the preferred method of treatment for this complex contingent of patients, however, despite significant advances in surgical treatment, simultaneous radical surgical correction is not always possible or causes severe complications in the immediate and long-term periods after surgery [3, 7, 9, 11].