Restrictive Atrial Septum Defect Becomes a Risk Factor for Norwood Palliation of Hypoplastic Left Heart Syndrome Only When It Is Combined with Mitral or Aortic Atresia.

Background: Restrictive atrial septal defect (ASD) is described as risk factor for Norwood procedure because of elevated pulmonary resistance. We hypothesized that it invariably could not cause pulmonary hypertension, unless it was combined with mitral valve or aortic valve atresia. We investigated how restrictive ASD influenced survival of patients with hypoplastic left heart syndrome (HLHS) who underwent Norwood operation.

The Taussig-Bing anomaly: long-term results.

Objectives: The arterial switch operation (ASO) is the method of choice for the Taussig-Bing heart. The aim of the study was to analyse the long-term outcome of correction of the Taussig-Bing heart.

Methods: Between 1986 and 2011, 44 infants, including 18 newborns, underwent an ASO.

Quantification of morbidity associated with congenital heart surgery.

Objective: The objective of this study was to estimate the morbidity according to observed complications after congenital heart surgery over 1-year period.

Methods: The previously established list of conditions prone to affect patients' well-being or increase cost of in-hospital stays was used systematically to score the severity of postoperative complications from 1 to 4 points. The morbidity score was calculated by adding the scores of observed complications.

Cone reconstruction of Ebstein's anomaly in a neonate.

Neonatal repair of Ebstein's anomaly is challenging and should be considered only if medical measures to stabilize the circulation and provide antegrade pulmonary blood flow fail. Anatomic repair, based on the cone reconstruction technique, has demonstrated promising survival benefits in older patients; however, there are no data regarding neonatal repair. This is a report on a successful salvage operation using cone reconstruction of Ebstein's anomaly in a neonate who had required extracorporeal membrane oxygenation support before surgery and who had failed to wean.

A morbidity score for congenital heart surgery based on observed complications.

Objectives: The aim of this study was to develop a morbidity score based on observed postoperative complications after congenital heart surgery.

Methods: Conditions or diseases that impair patients after congenital heart surgery or increase costs of hospital stay were called complications and attributed to scores ranging from 1 (mild) to 4 (severe) points, according to estimated severity or costliness. 'No complication' was assigned 0.

Sinus node artery-preserving superior transseptal approach: a simple technique.

With the use of the superior transseptal approach during mitral valve surgery, good exposure of the mitral valve can be achieved with simple traction sutures, which minimize the risk of deformation of the mitral valve. For this reason, we routinely perform mitral valvoplasty using the superior transseptal approach; however, we, occasionally encounter cases that develop postoperative atrial dysrhythmia. We have therefore, devised a very simple technique for preservation of the sinus node artery in the superior transseptal approach, which is effective for reducing the incidence of postoperative sinus node dysfunction.

Sharp rib fragment threatening to lacerate the aorta in a patient with flail chest.

A 50-year-old man who was the victim of an accident during work was taken to the hospital. His chest radiograph and computed tomography (CT) scan showed pulmonary contusion, multiple rib fractures (left 5th to 1lth ribs), hemopneumothorax, and splenic rupture. On the fourth posttrauma day, CT showed bone particles of the ninth rib migrating to the thoracic aorta.

For more safety: no-knife stapling for vascular division during video-assisted thoracoscopic surgery.

Staple cutters facilitate video-assisted thoracoscopic surgery, but their potential malfunction at vascular division can threaten the patient's life. We have used no-knife staplers and have divided between the staple lines without event. We show this technique to be a risk management alternative.