Repair of aortic-left atrial fistula following the transcatheter closure of an atrial septal defect.

We describe the surgical treatment of an aortic-left atrial fistula that appeared 6 months after the placement of an Amplatzer septal occluder for closure of a large secundum atrial septal defect. Successful repair of the fistula was accomplished by a combined transatrial-transaortic approach similar to that used to repair the rupture of a sinus of Valsalva aneurysm.

Surgery for congenital heart disease in low-birth weight neonates: a comprehensive statewide Connecticut program to improve outcomes.

Low-birth weight (LBW) remains a significant risk factor in surgery for congenital heart disease (CHD). The timing of surgery and the choice of complete repair vs palliative measures are controversial issues. Delay of surgery to achieve weight gain may result in poorer outcomes.

Effect of enalaprilat on postoperative hypertension after surgical repair of coarctation of the aorta.

Objective: Hypertension in pediatric patients after surgical repair of coarctation of the aorta can be difficult to control and may lead to morbidity. The renin-angiotensin system mediates at least part of this hypertension. Enalaprilat, the only intravenous angiotensin-converting enzyme inhibitor, is used to treat hypertension in pediatric patients in other settings.

Intraoperative radiofrequency ablation of the atrium: effectiveness for treatment of supraventricular tachycardia in congenital heart surgery.

Background: Supraventricular tachycardia (SVT) is common in surgical patients with congenital heart disease. Ablation and maze operations have been shown to be effective in treating SVT, but these procedures can be complex and time-consuming because of variable anatomy and a thickened right atrium. To simplify and shorten these procedures, we used a long, flexible radiofrequency probe capable of producing long ablation lines quickly and effectively.