1/49. Left ventricle to pulmonary artery conduit in treatment of transposition of great arteries, restrictive ventricular septal defect, and acquired pulmonary atresia.Progressive cyanosis after banding of the pulmonary artery in infancy occurred in a child with transposition of the great arteries and a ventricular septal defect, and a Blalock-Taussig shunt operation had to be performed. At the time of correction a segment of pulmonary artery between the left ventricle and the band was found to be completely occluded so that continuity between the left ventricle and the pulmonary artery could not be restored. A Rastelli type of operation was not feasible as the ventricular septal defect was sited low in the muscular septum. Therefore, in addition to Mustard's operation, a Dacron conduit was inserted from the left ventricle to the main pulmonary artery to relieve the obstruction. Postoperative cardiac catheterization with angiocardiography indicated a satisfactory haemodynamic result. The patient remains well 11 months after the operation. This operation, a left ventricle to pulmonary artery conduit, may be used as an alternative procedure in patients with transposition of the great arteries, intact interventricular septum, and obstruction to the left ventricular outflow, if the obstruction cannot be adequately relieved.- - - - - - - - - - ranking = 1keywords = atresia (Clic here for more details about this article) |
2/49. Divided left atrium in association with tricuspid atresia and discordant ventriculo-arterial connections.Division of the morphologically left atrium is a rare abnormality, constituting around 0.1% of congenital heart disease. It may coexist with other cardiac abnormalities, and this association may obscure its recognition. We report an uncommon association with tricuspid atresia and discordant ventriculo-arterial connections, the latter dominating the clinical picture. Accurate diagnosis was made by transthoracic cross-sectional echocardiography, and the patient was referred to surgery without need for cardiac catheterisation.- - - - - - - - - - ranking = 1.25keywords = atresia (Clic here for more details about this article) |
3/49. 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 = 1.25keywords = atresia (Clic here for more details about this article) |
4/49. Transposition of the great arteries, pulmonary atresia, and multiple ventricular septal defects associated with multiple cardiac rhabdomyomas in a case of tuberous sclerosis.Multiple cardiac rhabdomyomas are frequently associated with tuberous sclerosis. However, very few cardiac malformations have been described with tuberous sclerosis. We report an unusual case of tuberous sclerosis with cerebral and renal lesions associated with dextrotransposition of the great arteries, pulmonary atresia, patent ductus arteriosus, multiple ventricular septal defects, and parachute mitral valve deformity. After reviewing other cases of congenital heart diseases associated with tuberous sclerosis, emphasis is made on the potential influence of multiple rhabdomyomas developing very early during fetal life on final cardiac structures.- - - - - - - - - - ranking = 1.25keywords = atresia (Clic here for more details about this article) |
5/49. Congenitally corrected transposition with pulmonary atresia and intact ventricular septum.We describe a patient with the rare association of the heart in the left chest, congenitally corrected transposition, pulmonary atresia and an intact ventricular septum. There were associated fistulous communications between the morphologically left ventricle and the coronary arteries. diagnosis was made by echocardiography, and subsequently confirmed by cardiac catheterization.- - - - - - - - - - ranking = 1.25keywords = atresia (Clic here for more details about this article) |
6/49. dilatation of a restrictive interatrial communication using a balloon angioplasty catheter.Balloon atrioseptostomy is a life-saving procedure palliating certain congenital heart defects like transposition of the great arteries, right or left atrioventricular valve atresia, hypoplastic left heart syndrome, and pulmonary hypertension. Occasionally the Rashkind balloon septostomy technique may be ineffective in creating an adequate interatrial communication. We performed balloon dilatation of a restricted atrial septal defect using a balloon angioplasty catheter in a three-month-old infant.- - - - - - - - - - ranking = 0.25keywords = atresia (Clic here for more details about this article) |
7/49. The conduction system in tricuspid atresia with and without regular (d-) transposition.This is a serial section examination of conduction system in six hearts with tricuspid atresia. Four had regular (d-) complete transposition and two did not have transposition. The conduction system was more or less the same in all the hearts. The atrioventricular (A-V) node was in the normal position posteriorly and was short. The A-V bundle was situated in the left ventricular aspect of the subendocardium and passed posteriorly to the ventricular septal defect. Even though this type of conduction system is abnormal in some respects, it is not the type one finds in single ventricle with small outlet chamber with regular (d-) transposition. In those hearts an anteriorly located A-V node is present. These findings further substantiate the concept that tricuspid atresia with or without transposition is not a form of single (primitive) ventricle.- - - - - - - - - - ranking = 1.5keywords = atresia (Clic here for more details about this article) |
8/49. Combined transhepatic and transjugular approach for radiofrequency ablation of an accessory pathway in a child with complex congenital heart disease.We report on a boy with recurrent drug resistant atrioventricular reentrant tachycardia. The patient had complex structural heart disease consisting of right atrial isomerism, systemic venous anomaly (mirror image orientation of the intrathoracic veins, hemiazygos continuation to the left-sided superior vena cava, with separate drainage of the hepatic veins into the left-sided atrium, congenitally corrected transposition (ccTGA), pulmonary atresia (PA), ventricular and atrial septal defects (VSD and ASD). At the age of 22 months RF ablation was performed. Access to the heart was obtained by percutaneous puncture of a hepatic vein, the left internal jugular vein, and femoral artery. Earliest retrograde atrial conduction during tachycardia was localized to the free wall of the left-sided AV groove, and ablation in this area was successful. There were no procedure-related complications. RF ablation of accessory pathway is feasible in young children with complex structural heart disease and abnormal systemic venous return. In such patients access to the heart must be planned with the knowledge of the anatomy and judicious use of the hepatic venous approach, which should be done only by experienced investigators.- - - - - - - - - - ranking = 0.25keywords = atresia (Clic here for more details about this article) |
9/49. Transcatheter occlusion of a residual muscular ventricular septal defect using an Amplatzer duct occluder in a child with congenitally corrected transposition of the great arteries.Transcatheter occlusion has become an acceptable alternative to surgery in patients with congenital muscular and residual post-surgical ventricular septal defects (VSD). We present a case of an 11 year old male with congenitally corrected transposition of the great arteries, dextrocardia, pulmonary atresia, VSD, and advanced second degree atrioventricular block who underwent successful transcatheter occlusion of a residual post-surgical VSD with an Amplatzer duct occluder, in preparation for transvenous pacemaker implantation.- - - - - - - - - - ranking = 0.25keywords = atresia (Clic here for more details about this article) |
10/49. Palliative repair of aortic atresia associated with tricuspid atresia and transposition of the great arteries.Successful palliative repair of aortic atresia and hypoplastic aortic arch associated with tricuspid atresia in a neonate is described. The repair consisted of reconstruction of the hypoplastic aortic arch with an equine pericardial patch, division of the patient ductus arteriosus, connection of the pulmonary artery to the aorta, implantation of the proximal part of the ascending aorta into the main pulmonary artery, and anastomosis of a polytetrafluoroethylene graft 5 mm in diameter between the right ventricular outflow tract and the central pulmonary artery, which was transferred anteriorly to the main pulmonary artery.- - - - - - - - - - ranking = 2.5keywords = atresia (Clic here for more details about this article) |
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