Root translocation in congenitally corrected transposition of the great arteries with ventricular septal defect and pulmonary stenosis, and other lesions.

The pulmonary root translocation (PRT) procedure has been used to correct ventriculoarterial discordance or malposition of great arteries since 1994. It was part of the surgical repair of 62 consecutive patients presenting with congenitally corrected transposition of the great arteries (CCTGA) with ventricular septal defect (VSD) and pulmonary stenosis (PS), or other complex congenital heart disease with malposition of the great arteries, VSD, and PS. PRT was performed as follows: removal of the pulmonary artery (PA) with the pulmonary valve from its abnormal position, closure of the consequent hole with an autologous pericardial patch, resection of some conal septum, creation of an intraventricular tunnel connecting the left ventricle to the aorta, and construction of a new right ventricular outflow tract using the translocated PA.

Initial experience with the buttonhole technique in a Brazilian hemodialysis center.

Introduction: The most commonly used technique of arteriovenous fistula cannulation for hemodialysis is the rope-ladder technique with alternation of the cannulation site. An alternative technique, the buttonhole (BH) technique, has become popular because its constant cannulation sites are advantageous for patients with special characteristics.

Objective: To assess the initial experience of our service with the BH technique and determine its usefulness.