[Show abstract][Hide abstract] ABSTRACT: Crossed pulmonary arteries (CPAs) is a rare anomaly in which the left pulmonary artery (PA) originates to the upper right of the right PA and both PAs cross each other. CPAs is asymptomatic and presents little risk of perioperative complications. Here we report two cases of 22q11.2 deletion syndrome with CPAs and interruption of the aortic arch (IAA). In both cases, there was severe left branch PA stenosis after arch repair of the IAA. Percutaneous balloon angioplasty for the stenosis was not effective and left pulmonary angioplasty was performed. Left branch PA stenosis in CPAs is assumed to be due to the unique form of the pulmonary branches or the geometry change of the left PA caused by the arch repair.
[Show abstract][Hide abstract] ABSTRACT: We describe here successful palliative repair of tricuspid atresia, hypoplastic right ventricle, transposition of the great arteries, and hypoplastic aortic arch in a neonate. The repair consisted of the Norwood procedure with a rudimentary right ventricle to pulmonary artery shunt, which was located on the right side of a neo-aorta. This procedure could be a useful adjunct to avoid left ventriculotomy and its subsequent dysfunction.
No preview · Article · Dec 2010 · General Thoracic and Cardiovascular Surgery
[Show abstract][Hide abstract] ABSTRACT: Surgical exposure and accurate closure of a ventricular septal defect with a membranous septal aneurysm beneath the septal tricuspid leaflet carries a risk of tricuspid valve dehiscence and conduction disturbances when the septal leaflet is detached along the tricuspid annulus. To avoid these problems, we use a radial incision to expose and close perimembranous ventricular septal defects. We reviewed recent cases to determine the risks and benefits of this technique. From January 2005 through September 2008, 30 patients underwent closure of a perimembranous ventricular septal defect through a right atrial approach at our institution. The operation included radial incision of the membranous septal aneurysm to improve visualization of the perimembranous ventricular septal defect in 9 patients. There was no perioperative or late death. The operative and postoperative courses were uneventful in all cases. A residual leak was detected in only one patient. No patient had more than mild postoperative tricuspid valve insufficiency, none underwent reoperation, and no new arrhythmia or conduction disturbance was detected during follow-up. The radial incision for closure of a ventricular septal defect with a membranous septal aneurysm provides satisfactory exposure of the defect through the right atriotomy, for safe and accurate closure.
No preview · Article · Jun 2010 · Asian cardiovascular & thoracic annals