Achieving successful repair of congenital heart defects requires attention to detail. Careful evaluation anastomotic site patency, reimplanted coronary arteries, location epicardial coronaries, and myocardial perfusion may be necessary ensure safe conduct the operation achieve excellent outcomes.Intraoperative fluorescence angiography (IOFA) was performed using indocyanine green in patients undergoing following procedures: artery reimplantation, unroofing, intraoperative anatomy, reoperation...

HeartMate III is an emerging, small-sized centrifugal ventricular assist device. Its lower pump thrombosis and stroke rates make it favorable for use in pediatrics. We report the of as a bridge to transplantation adolescent with failed Fontan circulation. (Level Difficulty: Advanced.)

Central MessageThe double shunt technique (systemic-to-pulmonary artery, and aorto-tricuspid-right ventricular shunts), is a good initial palliation in PA/IVS right ventricle-dependent coronary circulation.See Commentaries on pages 222 224.Pulmonary atresia with intact septum (PA/IVS) rare congenital heart defect broad spectrum that associated varying degrees of tricuspid valve (TV) (RV) hypoplasia wide range abnormalities. The most extreme form ventricular-dependent circulation (RVDCC),...

Myocardial bridging is a controversial topic that remained with no well-defined management protocol. We present ten-year-old child Noonan syndrome and myocardial bridge.

Central MessageAortic translocation for circumflex aorta causing tracheobronchial compression can be performed safely on a beating heart using normothermic cardiopulmonary bypass via dual arterial cannulation.See Commentary page 243. Aortic cannulation. See The first description of aortic uncrossing was in 1984 by Planché and LaCoeur-Gayet.1Planché C. LaCoeur-Gayet F. compressive aorta: 3 cases.Press Med. 1984; 13: 1331-1332PubMed Google Scholar This procedure allows the retroesophageal...

Objective Median sternotomy has been the standard for pulmonary valve replacement (PVR) in patients with free regurgitation (PR) and right ventricular enlargement. With introduction of transcatheter therapy, search an alternate to is mandated. We present our early experience a limited anterior left thoracotomy approach. Methods used mini-thoracotomy six male (15 ± 1.94 years age) who developed progressive enlargement due chronic PR. Results Primary diagnoses were tetralogy Fallot five...

Arrest in the embryologic intestinal rotation around superior mesenteric artery prevents proper attachment and subjects gut to volvulus ischemia which may lead bowel resection. The length of non-viable resected has been shown by Teitelbaum et al. be an independent predictor survival patients with postoperative short syndrome (RR = 5.74, P .003). Non-occlusive (NOMI) is a feed-forward loop vasoconstriction that aggravates primary ischemic injury. It initially reversible process potential...

Repairing a complete vascular ring in adults can be challenging. A right aortic arch with an aberrant retro-oesophageal left subclavian artery and persistent diverticulum of Kommerell represents one the most common variants seen adults, is completed by left-sided ligamentum arteriosum. Most presentations occur secondary to oesophageal compression, resulting varying degrees dysphagia. Owing difficulty challenges associated exposure it not unusual for surgeons offer two-incision approach or...

This tutorial describes in detail the surgical technique of bilateral branch pulmonary arterial reconstruction a 10-month-old boy with Alagille syndrome and advanced liver disease. The procedure was performed via standard median sternotomy moderate hypothermia involves arterioplasties combined relief valvular supravalvular stenosis subtotal closure secundum atrial septal defect. patient presented systemic/suprasystemic right ventricular pressure.

Avoiding cardiopulmonary bypass during palliation of single ventricle has the advantages minimizing transfusions, pulmonary vascular resistance, and avoiding inflammatory response from bypass. It is however not always straightforward, technique may be faced with challenges.

Ventricular assist device (VAD) management continues to be a challenge in the presence of restrictive physiology. Left atrial (LA) decompression is not satisfactory even with good function and position left ventricular cannula. We describe an alternate approach LA cannulation via appendage (LAA) as rescue strategy patient who had physiology, our case was secondary viral myocarditis acute systolic heart failure subsequent insidious diffuse endomyocardial fibrosis superimposed massive...

Truncus arteriosus is a rare cardiac anomaly, accounting for less than 4% of all congenital lesions. It the result failed aorticopulmonary septation during fifth week gestation leading to single arterial trunk overriding interventricular septum, semilunar valve, and typically large conotruncal ventricular septal defect. Several classifications exist, it requires surgical repair in neonatal period. We present 5-day old female neonate who was diagnosed postnatally with type I truncus which...

The patient is a 5-year-old girl who underwent previous Kawashima procedure with left-sided bidirectional cavopulmonary anastomosis as stage I palliation for her functional single ventricle. Her cardiac defect consisted of an unbalanced, right-dominant complete atrioventricular septal and double outlet right She also had heterotaxy syndrome left isomerism, polysplenia, interrupted inferior vena cava azygous continuation to right-sided superior cava. native main pulmonary artery was in...

Introduction: ATLS® does not recommend routine chest CT in stable trauma patients. Many centers use Chest CT. We assessed the utility of Methods: we retrospectively 458 patients at our level 1 center that had both a x-ray[cx-ray] and as part initial work-up. Assessment whether findings were different from cx-ray if they led to change management was noted for each patient. The separated into 2 groups; data correlated group [chest x-ray data] non-correlated group. groups compared with one-way...

Anomalous aortic origin of the pulmonary artery is rare. It can affect either main branches and be an important cause neonatal respiratory distress. Early diagnosis surgical repair associated with improved survival long-term outcomes.

We report a 6-year-old with single ventricle physiology secondary to tricuspid atresia who had cardiorespiratory failure was not candidate for further palliation. The patient underwent planned staged left pneumonectomy recurrent pneumonias bronchomalacia followed by orthotopic heart transplantation. This aggressive approach improved the candidacy transplantation removing source of infection and respiratory (left lung).

Spinal cord injury secondary to coarctation repair in children is a serious, though relatively uncommon, complication. Several measures have been proposed minimize this risk, which seems affect more older than neonates and those with inadequate collateral circulation. Left heart bypass has as protective strategy.