One-stage repair of interrupted aortic arch, ventricular septal defect, and subaortic obstruction in the neonate: A novel approach Giovanni Battista.

Slides:

Advertisements

Similar presentations

Repair of Truncus Arteriosus With Interrupted Aortic Arch

Advertisements

Shunji Sano, MD, Kozo Ishino, MD, Masaaki Kawada, MD, Osami Honjo, MD

Ravi K. Ghanta, MD, John A. Kern, MD

James S. Tweddell, MD, Michael E. Mitchell, MD, Ronald K

Surgical treatment of subaortic stenosis after biventricular repair of double-outlet right ventricle Emre Belli, MD, Alain Serraf, MD, François Lacour-Gayet,

Roger J.F. Baskett, MD, David B. Ross, MD

The left ventricular outflow tract in atrioventricular septal defect revisited: Surgical considerations regarding preservation of aortic valve integrity.

Total Artificial Heart Replacement With 2 Centrifugal Blood Pumps

Sinus Venosus Atrial Septal Defect: Repair with an Intra-Superior Vena Cava Baffle Brian W. Duncan, MD Operative Techniques in Thoracic and Cardiovascular.

The Arterial Switch Operation: The “Open” Technique for Coronary Transfer Joseph M. Forbess, MD Operative Techniques in Thoracic and Cardiovascular Surgery

Operative Methods Used for Heart Transplantation in Complex Univentricular Heart Disease and Variations of Atrial Situs Jose Montalvo, MD, Leonard L.

The Aortic Translocation (Nikaidoh) Operation

Ravi K. Ghanta, MD, John A. Kern, MD

En-bloc Rotation of the Truncus Arteriosus—A Technique for Complete Anatomic Repair of Transposition of the Great Arteries/Ventricular Septal Defect/Left.

Transventricular Repair of Tetralogy of Fallot

Shunji Sano, MD, Kozo Ishino, MD, Masaaki Kawada, MD, Osami Honjo, MD

The Yasui Operation Kirk R. Kanter, MD

Osami Honjo, MD, PhD, Vivek Rao, MD

Repair of Tetralogy of Fallot with Absent Pulmonary Valve Syndrome

George M. Alfieris, MD, Michael F. Swartz, PhD

Repair of Supracardiac Total Anomalous Pulmonary Venous Return

The Ross/Konno Procedure

Sitaram M. Emani, MD, Pedro J. del Nido, MD

Anatomic Repair of Recurrent Aortic Arch Obstruction

Coarctation of the aorta with right aortic arch and isolation of the left innominate artery: A surgical challenge in a patient without collateral posterior.

The practical clinical value of three-dimensional models of complex congenitally malformed hearts Eugénie Riesenkampff, MD, Urte Rietdorf, MSc, Ivo Wolf,

Paul M. Kirshbom, MD, James J. Jaggers, MD, Ross M. Ungerleider, MD

Coarctation Aortoplasty: Repair for Coarctation and Arch Hypoplasia with Resection and Extended End-to-End Anastomosis Victor Tsang, MD, Sunjay Kaushal,

An alternate approach to valve replacement in patients with mitral stenosis and severely calcified annulus Sameh M. Said, MD, Hartzell V. Schaff, MD

William M. DeCampli, MD, PhD, Craig E. Fleishman, MD, David G

Cavo-Atrial Anastomosis Technique for Partial Anomalous Pulmonary Venous Connection to the Superior Vena Cava—The Warden Procedure Robert A. Gustafson,

Beyond Extended Myectomy for Hypertrophic Cardiomyopathy: The Resection- Plication-Release (RPR) Repair Sandhya K. Balaram, MD, PhD, Mark V. Sherrid,

Surgical Approach to Left Ventricular Inflow Obstruction Due to Dilated Coronary Sinus Florentino J. Vargas, MD, Jorge Rozenbaum, MD, Ricardo Lopez, MD,

Intra-atrial rerouting by the posterior left atrial wall flap for total anomalous pulmonary venous return drainage into the coronary sinus in neonates

The clamshell incision for bilateral pulmonary artery reconstruction in tetralogy of fallot with pulmonary atresia Giovanni Battista Luciani, MDa, Winfield.

Mobilization of the left and right fibrous trigones for relief of severe left ventricular outflow obstruction Magdi Yacoub, FRCS, FRCP, Obed Onuzo, MRCP,

Absent Pulmonary Valve Repair

Konno Procedure (anterior aortic annular enlargement) for Mechanical Aortic Valve Replacement Hiromi Kurosawa Operative Techniques in Thoracic and Cardiovascular.

Transposition of the great arteries {S, D, L}

Transatrial and transmitral myectomy for hypertrophic obstructive cardiomyopathy of the left ventricle Hikaru Matsuda, MD Operative Techniques in Thoracic.

James S. Tweddell, MD, Michael E. Mitchell, MD, Ronald K

Double-outlet right ventricle with complete atrioventricular canal

Stage I Norwood: The Birmingham Children’s Hospital Approach

Extended aortic replacement for acute type a dissection with the tear in the descending aorta Terushisa Kazui, MD, Yukihiko Tamiya, MD, Toshiaki Tanaka,

Anatomic correction of the syndrome of prolapsing right coronary aortic cusp, dilatation of the sinus of valsalva, and ventricular septal defect Magdi.

Midline one-stage complete unifocalization and repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals V.Mohan.

Surgical management of trabecular ventricular septal defects: The sandwich technique Yoshio Ootaki, MD, Masahiro Yamaguchi, MD, Naoki Yoshimura, MD, Shigeteru.

Kazunobu Hirooka, Charles D. Fraser The Annals of Thoracic Surgery

Pulmonary root translocation for biventricular repair of double-outlet left ventricle with absent subpulmonic conus Doff B. McElhinney, MS, V.Mohan Reddy,

“Lateral” Approach to Surgical Repair of Total Anomalous Pulmonary Venous Return Charles D. Fraser, MD Operative Techniques in Thoracic and Cardiovascular.

Conotruncal Repair For Tetralogy Of Fallot: Midterm Results

Tarek Alsaied, MD, MSc, Kevin Friedman, MD, Marco Masci, MD, David M

Doff B. McElhinney, MSa, V. Mohan Reddy, MDa, Michael M

Modified Rastelli procedure for double outlet right ventricle with left-malposition of the great arteries: report of 9 cases Qingyu Wu, MD, Qibin Yu,

Stage I—The Philadelphia Approach

Fixed left ventricular outflow tract obstruction in presumed hypertrophic obstructive cardiomyopathy: implications for therapy Charles J Bruce, MB, Rick.

Total Artificial Heart Replacement With 2 Centrifugal Blood Pumps

Double-Root Translocation for Double-Outlet Right Ventricle With Noncommitted Ventricular Septal Defect or Double-Outlet Right Ventricle With Subpulmonary.

Surgical closure of apical ventricular septal defects through a right ventricular apical infundibulotomy Giovanni Stellin, MD, Massimo Padalino, MD,

A new surgical technique for one-stage repair of interrupted aortic arch with valvular aortic stenosis Masaaki Yamagishi, MD, Katsuji Fujiwara, MD, Yoshiaki.

AORTIC VALVE–PRESERVING PROCEDURE FOR ENLARGEMENT OF THE LEFT VENTRICULAR OUTFLOW TRACT AND MITRAL ANULUS Richard A. Jonas, MD, John F. Keane, MD, James.

George M. Alfieris, MD, James J. Gangemi, MD, Mathew P

The relationship of the outlet septum to the aortic outflow tract in hearts with interruption of the aortic arch Hala M.F. Al-Marsafawy, MD*, Siew Yen.

Technique of Aortic Translocation for the Management of Transposition of the Great Arteries with a Ventricular Septal Defect and Pulmonary Stenosis Victor.

Arterial Switch Operation: Operative Approach and Outcomes

Half-turned truncal switch operation for complete transposition of the great arteries with ventricular septal defect and pulmonary stenosis Masaaki Yamagishi,

Commentary: It's all about the distal

The modified norwood procedure for hypoplastic left heart syndrome: Early to intermediate results of 120 patients with particular reference to aortic.

Echo-free perfused spaces: A current postoperative finding after homograft replacement of the aortic valve T. Carrel, MD, M. Pasic, MD, E. Oechslin,

Right ventricle-sparing heart transplant: promising new technique for recipients with pulmonary hypertension John A Elefteriades, MD, Costantinos J Lovoulos,

Presentation transcript:

One-stage repair of interrupted aortic arch, ventricular septal defect, and subaortic obstruction in the neonate: A novel approach Giovanni Battista Luciani, MDa,c, Ruben J. Ackerman, MDb,d, Anthony C. Chang, MDa,c, Winfield J. Wells, MDa,c, Vaughn A. Starnes, MDa,c The Journal of Thoracic and Cardiovascular Surgery Volume 111, Issue 2, Pages 348-358 (February 1996) DOI: 10.1016/S0022-5223(96)70444-0 Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 1 Parasternal long-axis view of the LVOT during diastole in a patient with IAA-VSD-SAS. The posterior displacement of the conal septum causing subaortic obstruction is evident. LA, Left atrium; LV, left ventricle; Ao, ascending aorta; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 348-358DOI: (10.1016/S0022-5223(96)70444-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Technique of one-stage repair of IAA-VSD-SAS. Thorough dissection of the origin of the brachiocephalic vessels, the branch pulmonary arteries and the descending thoracic aorta 1 to 2 cm distal to the isthmic region was completed. Selective ascending aortic and pulmonary arterial cannulation was performed with a 14F intravenous catheter and a 10F arterial cannula, respectively. A single straight 16F venous-return cannula was inserted through the right atrial appendage. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 348-358DOI: (10.1016/S0022-5223(96)70444-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Technique of one-stage repair of IAA-VSD-SAS. After drainage of the circulation, the cannulas were removed from the field. The ductus was divided and the proximal end of it was oversewn with running 7-0 Prolene monofilament sutures. All ductal tissue was carefully resected from the aorta. Any aberrant subclavian artery was divided at this point. A vertical incision was performed, extending from the base of the right carotid to the proximal ascending aorta. An end-to-end anastomosis of the ascending to the descending thoracic aorta was then completed with a continuous 7-0 Prolene suture. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 348-358DOI: (10.1016/S0022-5223(96)70444-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 Technique of one-stage repair of IAA-VSD-SAS. The VSD and SAS were addressed through a transpulmonary approach. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 348-358DOI: (10.1016/S0022-5223(96)70444-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 Technique of one-stage repair of IAA-VSD-SAS. A transverse pulmonary arteriotomy was performed approximately 5 mm above the valve and the margins of malalignment VSD were exposed. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 348-358DOI: (10.1016/S0022-5223(96)70444-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 6 Technique of one-stage repair of IAA-VSD-SAS. The original features of the technique consisted of (1) tailoring the patch to the shape of the defect but downsizing its area, to avoid bulging toward the LVOT and (2) positioning the stitches relative to the apical portion of the VSD patch on the left side of the conal septum to promote deflection of the displaced septum (dashed line) away from the LVOT. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 348-358DOI: (10.1016/S0022-5223(96)70444-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 7 Parasternal long-axis view of the LVOT during systole in the same patient after one-stage repair of IAA-VSD-SAS. The anterior deflection of the conal septum by the VSD patch allows successful relief of the subaortic obstruction. LA, Left atrium; LV, left ventricle; Ao, ascending aorta; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 348-358DOI: (10.1016/S0022-5223(96)70444-0) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 8 Plot of preoperative and follow-up (postoperative) systolic measurements of the SAD normalized to the DTA at the hiatus. Each line represents a single patient's data. Normalization of the size of the subaortic region after repair was achieved in every patient. The Journal of Thoracic and Cardiovascular Surgery 1996 111, 348-358DOI: (10.1016/S0022-5223(96)70444-0) Copyright © 1996 Mosby, Inc. Terms and Conditions