Pulmonary valve replacement and left pulmonary arterioplasty in repaired tetralogy of Fallot through left vertical axillary thoracotomy.

Different surgical approaches have been described for pulmonary valve replacement in patients with pulmonary regurgitation post tetralogy of Fallot repair-repeat median sternotomy, left anterior or antero-lateral thoracotomy, and left posterolateral thoracotomy. Every approach has its merits and drawbacks. In this case report, we describe a technique of pulmonary valve replacement and left pulmonary arterioplasty through left vertical axillary thoracotomy.

Single-Stage Unifocalization and Intracardiac Repair Using Two Tube Grafts.

Unifocalization of the major aortopulmonary collaterals (MAPCAs) followed by intracardiac repair with ventricular septal defect (VSD) closure and restoration of right ventricle-to-pulmonary artery continuity is the ultimate treatment goal in a case of VSD with pulmonary atresia and MAPCAs. It may be achieved in a single stage or may require multiple surgeries. We present a case of a 2-year-old boy with VSD with pulmonary atresia who underwent single-stage unifocalization of MAPCAs through the midline followed by intracardiac repair using 2 polytetrafluoroethylene tube grafts: one for unifocalization and other as a bicuspid valved right ventricle-to-pulmonary artery conduit.