Changing trends in the management of pulmonary atresia with intact ventricular septum: The Melbourne experience

Abstract

Objective: Management of pulmonary atresia with intact ventricular septum (PAIVS) can be directed to either biventricular repair or univentricular palliation. The optimal management strategy has yet to be defined. Methods: All patients operated at the Royal Children's Hospital, Melbourne for PAIVS between 1990 and 2006 (n= 81) were reviewed. Patients were retrospectively stratified into a simple three-tiered classification based on right ventricle (RV) size. Multivariate logistic regression analysis was performed to identify risk factors of mortality. Results: The distribution of RV sizes was normal in 11 (14%), moderate hypoplasia in 45 (56%), and severe hypoplasia in 25 (31%) patients. RV-..