Pediatric Cardiology and Cardiac Surgery
Vol.25 No.2 2009 (161-164)
Kazumasa Watanabe,1) Masaaki Koide,1) Yoshifumi Kunii,1) Nobuhiro Umehara,1) Tadahisa Sugiura,1) Shou Takeda,2) and Yasumi Nakashima2)
Departments of 1)Cardiovascular Surgery and 2)Pediatric Cardiology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
We report the case of a 6-month-old infant diagnosed with truncus arteriosus communis (type 1) with partial anomalous pulmonary venous return (PAPVR) as shown by angiography. He presented with cyanosis on postpartum day 1, and was diagnosed as having truncus arteriosus communis with PAPVR by echocardiography. We performed pulmonary artery banding at postpartum day 8. At the age of 6 months, he underwent Rastelli operation for the correction of truncus arteriosus communis, along with repair of PAPVR. During the operation, we recognized that the right middle and lower pulmonary veins returned to the right atrium. Therefore, intra-atrial rerouting was performed in addition to partial left upper pulmonary vein-left atrial appendage anastomosis. The postoperative course was good. A case of truncus arteriosus communis coexisting with partial anomalous pulmonary venous return is very rare, and the treatment results have not been satisfactory. In the case of truncus arteriosus communis with other coexisting congenital heart diseases, performing one-staged repair during the neonatal period is highly invasive and is accompanied with high perioperative risks. As shown by our experience, staged repair is feasible and provides a safer treatment strategy. We assessed this case with reference to the literature.