1/71. Left main coronary artery compression by aneurysmal pulmonary artery in a patient with tetralogy of fallot with absent pulmonary valve.We describe an 11-year-old girl with tetralogy of fallot and absent pulmonary valve, who on selective coronary angiography was found to have extrinsic compression of the left main coronary artery by the aneurysmally dilated pulmonary artery. This abnormality has not been reported previously.- - - - - - - - - - ranking = 1keywords = pulmonary valve, valve (Clic here for more details about this article) |
2/71. Rapid two-stage repair of S,L,L, ventricular septal defect, pulmonary atresia, ebstein anomaly of the tricuspid valve, and stenotic pulmonary arteries.The repair of a corrected transposition of the great arteries, ventricular septal defect, and pulmonary atresia is presented. An ebstein anomaly of the tricuspid valve, dextrocardia, and severe distortion of the pulmonary arteries complicated the surgical procedure, which was performed in two stages. Reconstruction of the pulmonary arteries and a bidirectional cavopulmonary anastomosis were performed first; Rastelli and hemi-Mustard procedures completed the correction. The rationale and the possible indications of this "one and a half ventricle" repair are discussed.- - - - - - - - - - ranking = 13.008420921689keywords = pulmonary atresia, atresia, valve (Clic here for more details about this article) |
3/71. Stenting of stenosed aortopulmonary collaterals and shunts for palliation of pulmonary atresia/ventricular septal defect.patients with unrepaired pulmonary artery atresia and ventricular septal defect (PA/VSD) depend on aortoplumonary collaterals and surgically created shunts for pulmonary blood flow. These vessels frequently develop stenoses with time, leading to hypoperfusion of lung segments and systemic hypoxemia. The purpose of this article is to describe catheter palliation of hypoxemic patients with PA/VSD who were not candidates for surgical repair. We present our experience with stent implantation for stenosis of aortopulmonary collaterals and shunts in these patients. Three patients with hypoplastic pulmonary arteries underwent stent placement in aortopulmonary collateral arteries (APCAs) or their shunts. Technical aspects of the interventional catheterization procedure are discussed in detail. Case 1 underwent placement of five stents in collateral vessels and one stent in the Blalock-Taussig shunt (BT) with dramatic increase in vessel size and improvement in saturations from 70% to 89%. Case 2 underwent placement of two overlapping stents in a collateral vessel with an increase in diameter of the collateral vessel from 2.3 to 6 mm and an improvement in saturation from 68% to 88%. Case 3 underwent placement of three overlapping stents in a BT shunt with an increase in diameter of the shunt from 2.2 to 6.6 mm and an improvement in saturation from 71% to 89%. All three patients had excellent clinical improvement and stable saturation at follow-up. Stent placement for maintaining patency of APCAs and aortopulmonary shunts is feasible and safe.- - - - - - - - - - ranking = 10.943076198769keywords = pulmonary atresia, atresia (Clic here for more details about this article) |
4/71. Bivalved palatal transposition flaps for the correction of acquired nasopharyngeal stenosis.Nasopharyngeal stenosis is almost universally an iatrogenic problem resulting from surgical trauma after adenotonsillectomy or uvulopalatopharyngoplasty (UPPP). In addition, laser-assisted uvulopalatopharyngoplasty for the treatment of snoring may lead to the development of cicatricial scarring and stenosis at the level of the velopharynx. The most common mechanisms implicated in the development of acquired nasopharyngeal stenosis are the overzealous removal of inferolateral adenoid tissue and excessive excision of the palatopharyngeal arches. Symptoms generally relate to a disturbance in respiration, olfaction, voice quality, and deglutition, and are often poorly tolerated. Surgical options for the correction of this challenging problem include steroid injections, scar lysis, skin grafts, Z-plasty repair, and the use of various local mucosal flaps. We report the successful use of bivalved palatal transposition flaps performed through the transoral route for the correction of severe acquired nasopharyngeal stenosis following UPPP in two patients. Both patients developed delayed nasopharyngeal stenosis following their initial surgery and subsequently failed several attempts at surgical correction of the stenosis, including laser lysis of the scarred soft palate. Using this technique of repair, both patients achieved satisfactory resolution of their symptoms, including comfortable nasal breathing and normal speech. We have found that this is a simple and effective technique for the correction of severe nasopharyngeal stenosis.- - - - - - - - - - ranking = 0.027796483990778keywords = valve (Clic here for more details about this article) |
5/71. Anomalous origin of the pulmonary artery from the right coronary artery.A 5-year-old boy who had an anomalous origin of a stenotic pulmonary artery from the right coronary artery with ventricular septal defect and pulmonary atresia is reported. The diagnosis was made at operation. Successful repair was achieved for the complex anomaly by using a pulmonary artery homograft as a conduit and closing the ventricular septal defect.- - - - - - - - - - ranking = 2.5961248875396keywords = pulmonary atresia, atresia (Clic here for more details about this article) |
6/71. Limb constriction as a complication of intra-uterine vesico-amniotic shunt: fetoscopic release.Complete fetal bladder outlet obstruction was first diagnosed in a fetus at 13.5 weeks. After sequential vesicocentesis had shown good renal function, a vesico-amniotic shunt was inserted at 17 weeks with a Rodeck catheter. The procedure was successful and amniotic fluid volume re-accumulated to normal levels. A detailed scan at 20 weeks showed that the distal free end of the catheter was wound round the left fetal thigh. As the fetus grew, there was progressive constriction of the fetal thigh by the catheter. By 29 weeks, Doppler blood flow changes to the left leg were apparent. Fetoscopic surgery was performed at 30 weeks to release the constriction. The catheter was divided successfully, but the divided end of the shunt subsequently retracted into the fetal abdomen, producing urinary ascites, bilateral hydroureter and hydronephrosis. The baby was delivered at 31.5 weeks in good condition. Endoscopic resection of anterior and posterior urethral valves was performed at 6 months of age. At 2 years, the child has normal renal function, growth parameters and developmental milestones. Mild indentation of the left thigh was still apparent, although there was no functional impairment.- - - - - - - - - - ranking = 0.0055592967981556keywords = valve (Clic here for more details about this article) |
7/71. A rare case of neonatal ileo-cecal valve stenosis due to covered iliac perforation.At birth, newborn babies tend to respond to any stressful event with elective blood shunting towards the main organ systems, such as the brain and heart. Consequently, the bowel may suffer from a severe flow reduction with a high risk of hypoperfusion. The distal ileum is relatively less vascularized than other parts of intestine, due to a lack of collateral arteriolar circulation. It is therefore at higher risk of hypoxia, tissue necrosis and perforation in situations of minimal hypoperfusion or spasm. A rare case of covered perforation of the last loop of the ileum in a severely preterm baby is reported. The perforation manifested atypically as inflammatory stenosis of the loop and the ileo-cecal valve. To avoid misdiagnoses and to manage these cases correctly, the caregiver has to consider this rare eventuality in the differential diagnosis of intestinal occlusion/subocclusion in the first days of life.- - - - - - - - - - ranking = 0.027796483990778keywords = valve (Clic here for more details about this article) |
8/71. choanal atresia repair. The use of reinforced silicone tube to prevent restenosis.There are different approaches for the repair of congenital choanal atresia. A stent is usually inserted in the nostrils to prevent restenosis. We describe a case of an infant who was presented with recurrent choanal stenosis and was managed by a stent made of reinforced silicone rubber tracheal tube. The tube has several advantages over other known stents.- - - - - - - - - - ranking = 2.792883243053keywords = atresia (Clic here for more details about this article) |
9/71. choanal atresia: an unusual serious complication of complementary and alternative medical treatment.The use of complementary and alternative medicine (CAM) is common among patients with chronic, long-standing nasal disease. Complications resulting from inappropriate CAM practices are sometimes reported, but serious complications such as choanal atresia and stenosis are rare. We report a case of choanal atresia and stenosis due to herbal drug (ie, chemical) cauterization of the nasal cavity in a 39-year-old man. We reviewed the literature on why patients previously given conventional treatment seek alternative therapies. The patient underwent surgical intervention to relieve choanal atresia and stenosis. The postoperative course was unremarkable, and follow-up for 1 year revealed no evidence of restenosis. choanal atresia and stenosis resulting from CAM treatment are rare. Otolaryngologists should be aware of possible complications occurring in patients receiving such treatments.- - - - - - - - - - ranking = 4.4686131888848keywords = atresia (Clic here for more details about this article) |
10/71. Valuable use of computer-aided surgery in congenital bony aural atresia.Congenital aural atresia repair is difficult owing to unpredictable anatomy. Benefits may be gained from computer-aided surgery (CAS), but its exact role has yet to be clearly defined. This is a retrospective study of 18 patients with bony type C (Schuknecht classification) congenital atresia. In the first group (n = 9), repair was performed with CAS while in the second group (n = 9), similar intervention was applied without CAS. Intra- and post-operative clinical and audiological findings were compared. CAS computed tomography (CT) images correlated well with intra-operative findings giving the surgeon more security and reducing operative time by 25 minutes. In our estimation, CAS is valuable for type C congenital aural atresia repair. It serves as an educational tool and as a guide for the experienced surgeon in critical situations where anatomical landmarks are distorted and where access is limited.- - - - - - - - - - ranking = 3.9100365402742keywords = atresia (Clic here for more details about this article) |
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