Introduction:
Stenosis or disconnection of the left pulmonary artery (LPA) is a
well-known anomaly associated with other congenital heart defects. It is
presumed to occur due to extension of ductal tissue into the wall of the
LPA. Although, bilateral branch pulmonary artery (PA) disconnection is
known, it most commonly occurs unilaterally. Non-confluent PAs are
supplied by 3 different sources viz. patent ductus arteriosus from
aortic arch system, collateral or bronchial arteries from descending
aorta or from a variation of persistent truncus
arteriosus1. Surgical repair of LPA stenosis /
disconnection, regardless of the technique employed, carries a
significant incidence of recurrent stenosis due to the presence of
ductal tissue and highlights the importance of removing all possible
ductal tissue from the LPA which sometimes compromises the length of
LPA. This also makes tension-free anastomosis impossible. In order to
circumvent these problems, we describe a novel way of restoring the
confluence of right pulmonary artery (RPA) with LPA by employing the
native, autologous pulmonary arterial tissue itself after removing all
ductal tissue to the best extent possible.