A new approach to repair of pulmonary branch stenosis following ascending aorta-right pulmonary artery anastomosis.

Ascending aorta-right pulmonary artery anastomosis may result in branch stenosis or occlusion of the right pulmonary artery from growth or from failure to place the anastomosis on the posterior surface of the aorta at the time of construction. Closure of the anastomosis is usually easily accomplished by simple suture through the ascending aorta. When branch stenosis is present at the site of anastomosis, reconstruction of the pulmonary artery is necessary. A new approach that facilitates repair of pulmonary branch stenosis by transecting the ascending aorta over the obstructed area has been utilized in 2 patients who required reoperation for branch stenosis following repair for tetralogy of Fallot. The method is an alternative approach to gain exposure for reconstruction of the pulmonary artery.