ABSTRACT
Sixteen patients less than 3 months of age underwent closed transventricular pulmonary valvotomy for critical pulmonary stenosis with intact ventricular septum. There were 14 survivors; the 2 deaths were unrelated to the technique. Early and late results reveal good hemodynamics in all but 1 patient who underwent open valvotomy four years later for restenosis. We have used this technique exclusively, as it is safe, requires little preparation for operative relief in the very sick infant, and the early and late results are excellent.
Subject(s)
Pulmonary Valve Stenosis/surgery , Pulmonary Valve/surgery , Follow-Up Studies , Hemodynamics , Humans , Infant , Infant, Newborn , Methods , Pulmonary Valve Stenosis/congenital , Pulmonary Valve Stenosis/mortality , Pulmonary Valve Stenosis/physiopathologyABSTRACT
An aorticopulmonary septal defect (APSD) results from failure of proper conotruncal separation. The hemodynamic consequences of this lesion closely resemble that of other large left-to-right shunt defects, especially a patent ductus arteriosus (PDA). Failure to differentiate these 2 abnormalities has not infrequently led to an inappropriate surgical approach in pursuit of the far more common PDA. This report describes the two-dimensional echocardiographic (2-DE) recognition of an APSD in 2 premature infants. Survival of these delicate neonates indicates that successful surgery can be performed even in small infants. A thorough 2-DE examination for an APSD is recommended for any infant before proceeding to surgery for a suspected PDA, especially when cardiac catheterization has not been performed.
Subject(s)
Aorta/abnormalities , Heart Septal Defects/diagnosis , Pulmonary Artery/abnormalities , Cardiac Surgical Procedures/methods , Diagnosis, Differential , Ductus Arteriosus, Patent/diagnosis , Echocardiography , Female , Heart Failure/diagnosis , Heart Septal Defects/surgery , Humans , Infant, NewbornABSTRACT
The technique we currently use for repair of complete atrioventricular canal requires 2 separate patches for closure of the atrial and ventricular portion of the defect. The common AV valve is left undivided and is sandwiched between these 2 patches. The cleft in the anterior mitral leaflet is left unsutured to create a trileaflet mitral valve. This technique has been employed in 10 patients (Type C: 9 patients; Type A: one patient; ages: 6 months to 4 1/2 years).
