ABSTRACT
We present an original surgical approach--posterolateral thoracotomy--for hybrid stage I procedure. This is a review of prospectively collected data on patients treated for hypoplastic left heart syndrome (HLHS) using a hybrid approach (n=33) between December 2007 and March 2010. The hybrid approach includes pulmonary artery bands, a ductal stent through posterolateral thoracotomy access. Overall survival was 88.5%. Our original surgical approach in hybrid stage I on patients treated for HLHS can yield acceptable intermediate results that are comparable with a traditional Norwood strategy. Potential advantages of the lateral thoracotomy in the hybrid approach include the avoidance of median sternotomy, minimal postoperative pericardial adhesions, better access to patent ductus arteriosus (PDA) stenting, the possibility of visual and manual control of the stent position, and short operative time.
Subject(s)
Cardiac Catheterization , Cardiac Surgical Procedures , Ductus Arteriosus, Patent/therapy , Hypoplastic Left Heart Syndrome/therapy , Thoracotomy , Cardiac Catheterization/adverse effects , Cardiac Catheterization/instrumentation , Cardiac Catheterization/mortality , Cardiac Surgical Procedures/adverse effects , Cardiac Surgical Procedures/mortality , Catheterization , Ductus Arteriosus, Patent/mortality , Ductus Arteriosus, Patent/surgery , Humans , Hypoplastic Left Heart Syndrome/diagnostic imaging , Hypoplastic Left Heart Syndrome/mortality , Hypoplastic Left Heart Syndrome/surgery , Infant , Infant, Newborn , Radiography , Russia , Stents , Thoracotomy/adverse effects , Thoracotomy/mortality , Time Factors , Treatment OutcomeABSTRACT
This report describes a rare case of anomalous origin of the right coronary artery from the pulmonary artery associated with a large aortopulmonary window in a 2-month-old boy. The right coronary artery was exposed to systemic pressure and carried fairly well-oxygenated blood to the myocardium. Closure of the aortopulmonary window alone could have caused acute myocardial ischemia. The purpose of this case report is to describe successful diagnosis and management of anomalous origin of the right coronary artery associated with an aortopulmonary window. The pathological findings and the physiological effects, clinical importance, and method of correction used are discussed.
