Successful video-assisted thoracoscopic atrial appendectomy in a 4-year-old child with intractable atrial tachycardia and tachycardia-induced cardiomyopathy.

A 4-year-old boy presented with intractable atrial tachycardia and heart failure. Antiarrhythmic drugs, such as digoxin, beta-blockers, and amiodarone were ineffective. Although we attempted multiple radiofrequency catheter ablations, the atrial tachycardia arising from left atrial appendage frequently recurred. Finally, we decided to perform atrial appendectomy using the thoracoscopic approach. Immediately after the appendectomy, the atrial tachycardia was terminated and restored to sinus rhythm. Left ventricular ejection fraction increased from 33 to 60% within 1 week. He had no arrhythmia during the subsequent 9-month follow-up period. Minimally invasive thoracoscopic surgery can be applied even in a small child who has focal atrial tachycardia originating from an atrial appendage.

Aortopexy and thymectomy through lower partial sternotomy for the treatment of airway compression in a patient with right lung agenesis.

We managed a case of extrinsic airway compression by adjacent structures in a 1-month-old boy with right lung agenesis and dextro-rotated heart using anterior aortopexy and near total thymectomy.