The Journal of thoracic and cardiovascular surgery
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Eighty-two consecutive patients with interrupted aortic arch were referred to our institution between 1985 and 1995. Three died before any attempt at operation and 79 underwent surgical repair. Median age at operation was 9 days (range 1 day to 6 years) and median weight was 3.0 kg (range 1.8 to 20 kg). ⋯ In conclusion, interrupted aortic arch remains a surgical challenge with continually improving results. Early diagnosis with preoperative resuscitation and adequate myocardial protection seem extremely important for further improvements. Associated subaortic stenosis or complex lesions
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J. Thorac. Cardiovasc. Surg. · Nov 1996
Superior vena cava to pulmonary artery anastomosis: an adjunct to biventricular repair.
From May 1981 to September 1995, 38 patients received a superior vena cava-pulmonary artery anastomosis in association with biventricular repair. Patients were divided into four groups on the basis of indication for operation. Group A (19 patients) had a small physiologic right ventricle defined by tricuspid anulus z values or predicted right ventricular volume. ⋯ With the use of this adjunctive approach, acceptable intermediate-term outcomes were obtained in patients having an anatomically or functionally compromised pulmonary ventricle. The anastomosis safely facilitates repair in a subset of patients. Results for this procedure when used as a salvage operation for right ventricular dysfunction have not been satisfactory.
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J. Thorac. Cardiovasc. Surg. · Nov 1996
Pulmonary artery growth after bidirectional cavopulmonary shunt: is there a cause for concern?
Our objective was to analyze changes in pulmonary artery size after bidirectional cavopulmonary shunt. ⋯ A more appropriate measure of pulmonary artery growth is the indexed cross-sectional area of the lower lobe branch of the right and left pulmonary arteries, which is less likely to be altered surgically with systemic-pulmonary shunts, pulmonary artery repair, and the bidirectional cavopulmonary anastomosis itself. Pulmonary artery indices, including the lower lobe index, do not change significantly after bidirectional cavopulmonary shunt during medium-term follow-up and do not influence the Fontan outcome.
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J. Thorac. Cardiovasc. Surg. · Nov 1996
Rationale of the Cox maze procedure for atrial fibrillation during redo mitral valve operations.
The frequency of reoperation for mitral valve diseases with chronic atrial fibrillation has increased steadily. This study examined the rationale for using the Cox maze operation for atrial fibrillation during redo mitral valve operations. ⋯ These results suggest that the maze procedure should be considered in selected patients who have a high possibility of regaining sinus rhythm during redo mitral valve operations.