Surgical treatment of infective endocarditis with massive vegetations in a patient with a ventricular septal defect and atopic dermatitis: a case report.

Background: It is well known that congenital heart disease, especially a ventricular septal defect, is associated with a high risk of infective endocarditis. There are few reports of infective endocarditis with vegetations extending from the right ventricle into the pulmonary artery, resulting in pulmonary artery embolism. It is also well known that atopic dermatitis can be associated with systemic infections such as infective carditis.

Mitral and tricuspid valve repair using interannular bridging in children.

Objectives: In children, it is difficult to control mitral valve (MV) or tricuspid valve (TV) regurgitation with conventional procedures alone because complex factors hamper easy improvement of valve coaptation. We investigated interannular bridging in children with MV/TV regurgitation.

Methods: The subjects were 9 patients who underwent interannular bridging to control TV or MV regurgitation between January 2014 and December 2021.

Hepatic-to-azygos vein redirection after a failed bifurcated graft Fontan conversion.

A successful hepatic-to-azygos vein redirection was performed in a patient with absent inferior vena cava using a long vascular graft to address a pulmonary arterio-venous fistula after a failed Fontan conversion. No exacerbation was observed 5 years postoperatively.

Simplified primum ASD closure technique in complete VSD repair: shallow suture crossing on the AV node.

The primum atrial septal defect suture line adjacent to the crux is performed carefully with various techniques to avoid atrioventricular block in repair of complete atrioventricular septal defect. We describe our technical modification to simplify the shallow suture line only into the endocardium above the atrioventricular node without conduction disturbance.

The Ventricular Hypokinesis at the Apical Pacing Site due to the Early Shortening and Rebound Stretch in a Case with Fontan Procedure.

The left ventricular (LV) apex is recommended as the first choice for positioning the epicardial pacing. We encountered a patient with congenital heart disease (CHD) showing hypokinesis of the LV apical pacing site after implantation of a pacemaker with epicardial leads. This phenomenon was revealed by the early shortening and systolic rebound stretch of the same lesion on two-dimensional speckle tracking echocardiography, which developed in the intraventricular dyssynchrony between the LV apex and base.

[Current Surgical Treatment for Patients with Hypoplastic Left Heart Syndrome, from the Viewpoint of Emergent Operation].

The treatment of hypoplastic left heart syndrome has improved dramatically with the development of treatment strategies due to improved understanding of hemodynamics, improved surgical methods, and the widespread use of fetal diagnosis. However, cases of early closure of the foramen ovale require emergency surgery immediately after birth, and further improvement of treatment results is needed. The right ventricular pulmonary artery shunt reported from Japan is well known worldwide and has greatly contributed to improved outcomes up to six months after the Norwood procedure.

Catheter Intervention for Flow Regulatory Clips on Palliative Shunts and Conduits in Patients with Congenital Heart Disease.

Catheter intervention (CI) for a Blalock-Taussig shunt (BTS) or a ventricle-to-pulmonary artery conduit (VPC) is often required after a palliative surgery for congenital heart disease. Flow regulatory clips help improve interstage mortality; their use necessitates CIs to prevent cyanosis. To study the CI outcomes in patients who underwent palliative surgery with either BTSs or VPCs with flow regulatory clips.

Pulmonary atresia with intact ventricular septum in the setting of D-transposition of the great arteries associated with hypoplastic left ventricle and severe mitral regurgitation.

We report the first successful Glenn procedure for pulmonary atresia with intact ventricular septum in the setting of D-transposition of the great arteries. This case was complicated by hypoplastic left ventricle and severe mitral regurgitation. Partial closure of the mitral valve at the time of Blalock-Taussig shunting resulted in improvement of heart failure.

Risk factors for mortality after cardiovascular surgery in patients with functional single ventricle and right isomerism.

Objectives: Cardiac malformations are a major component of heterotaxy syndrome that results in significant mortality and morbidity, especially in patients with a single ventricle and right isomerism (RI). The goal of this study was to evaluate the mortality after cardiovascular surgery in patients with a functional single ventricle and RI over a long follow-up period (∼40 years) and to determine the predicted risk factors for mortality.

Methods: We performed a retrospective review of the medical records of 129 consecutive patients with functional single ventricle and RI who underwent pulmonary flow control operations at Mt.

Open-sleeve technique: A new approach for aortic valve leaflet reconstruction in small children.

A boy was diagnosed with a unicuspid aortic valve with severe stenosis at birth. Percutaneous balloon aortic valvuloplasty was performed four times; however, he had severe heart and growth failure. Thus, aortic valve repair was performed at age 2 years and 6 months.

[Fontan Procedure in Hypoplastic Left Heart Syndrome:for Better Establishment of Fontan Circulation].

Recently, the number of patients with hypoplastic left heart syndrome reaching the final stage of Fontan operation is increasing due to the systematization of staged therapies including bilateral pulmonary artery banding. However, in case, the systemic and pulmonary circulatory pathways initially formed by the Norwood procedure are not always sufficient to obtain a good Fontan circulation. In particular, depending on the method of reconstruction of the aortic arch, aortic re-coarctation may result in increased ventricular afterload.

Primary central pulmonary artery plasty for right atrial isomerism with pulmonary coarctation.

Objective: Patients with unbalanced pulmonary artery growth resulting from pulmonary coarctation are considered unsuitable candidates for the Fontan procedure. Particularly, patients with right isomerism pose a challenge. We aimed to investigate the use of primary central pulmonary artery plasty at initial palliation in patients with right isomerism.

Truncal valve leaflet reconstruction with autologous pericardium in a neonate.

A boy diagnosed with persistent truncus arteriosus and severe truncal valve regurgitation had uncontrollable heart failure. Thus, truncal valve repair, ventricular septal defect closure, and right ventricular outflow tract reconstruction were performed on the second day of life. We report about a neonate with severe truncal valve regurgitation who was successfully treated with autologous pericardial truncal valve leaflet reconstruction.

Outcomes of primary sternal closure for postoperative mediastinitis in children.

Objectives: We retrospectively analysed outcomes of debridement and primary sternal closure for postoperative mediastinitis in children.

Methods: Between January 2007 and July 2019, 1285 patients under the age of 20 years underwent congenital heart surgery at the Iwate Medical University. Of these, 22 children had postoperative mediastinitis (1.

Fatal septic embolism due to Staphylococcus lugdunensis-induced bacteremia.

Staphylococcus lugdunensis infective endocarditis (IE) is very rare in children. A female neonote presented with fever on the 29th postoperative day after undergoing a modified Norwood procedure (right ventricular-pulmonary artery [RV-PA] conduit). Blood cultures were positive for S.

[Surgical Strategy for Pulmonary Atresia with Ventricular Septal Defect with Major Aortopulmonary Collateral Artery].

Although the characteristics and pathophysiology of major aortopulmonary collateral artery (MAPCA) have been better understood, treatment of pulmonary atresia and ventricular septal defect with MAPCA remains challenging. The difficulty in treating this disease is the lack of availability of pulmonary homografts required for pulmonary angioplasty in Japan and the need for manipulation of the posterior mediastinum region, which is not performed in normal cardiac surgery. It is important to build an appropriate surgical strategy by means of preoperative computed tomography( CT) and selective angiography.

Adult case of tetralogy of Fallot associated with atrioventricular septal defect.

The patient was a 28-year-old woman who was misdiagnosed with tetralogy of Fallot and straddling mitral valve after birth. She underwent a left modified Blalock-Taussig shunt at the age of 1 year. At age 28, she presented with fatigue and progressive cyanosis.

Intra-Extracardiac Total Cavopulmonary Connection for Patients With Anatomical Complexity.

Background: Currently, the extracardiac conduit total cavopulmonary connection (eTCPC) is the most widely used for Fontan modification worldwide. Nevertheless, there have been some cases that are difficult for performing eTCPC because of their anatomical complexity, such as apicocaval juxtaposition. For such cases, in 2002, we introduced the intra-extracardiac TCPC (ieTCPC).

Interannular Bridge: A Novel Approach to Address Congenital Mitral Regurgitation.

A male infant with Kabuki syndrome had trivial congenital mitral regurgitation diagnosed at birth. At the age of 2 years and 9 months, the regurgitation worsened from mild to severe; thus, expedited surgical treatment was pursued. The primary operative finding was severe dysplastic two-leaflet disease.

Impact of intrapulmonary-artery septation to pulmonary vein obstruction for two-lung Fontan.

Objectives: Patients with unbalanced pulmonary artery (PA) growth and decreased unilateral pulmonary circulation are considered unsuitable candidates for the Fontan procedure. Following our previous study on the utility of intrapulmonary-artery septation for patients with PA hypoplasia, we investigated its use in patients with pulmonary venous obstruction (PVO).

Methods: We recruited 42 patients who underwent intrapulmonary-artery septation for unilateral PA hypoplasia and/or PVO between 1998 and 2018 and classified them into no PVO or PVO group.