A systematic approach to epicardial echocardiography in pediatric cardiac surgery: An important but underutilized intraoperative tool.

Intraoperative echocardiography is an integral component of the peri-operative management of pediatric heart disease. It confirms the adequacy of surgery, identifies residual lesions, and can provide useful hemodynamic data. It, therefore, helps to decide on the need for revision of repair and guides the postoperative management strategy.

Double outlet of both ventricles: morphological, echocardiographic and surgical considerations.

Objectives: To describe the morphology, echocardiographic features and surgical management of the entity appropriately described as 'double outlet of both ventricles'.

Methods: Seven patients (5 males, age 0.5-7.

Mid-Term Follow-Up of Neonatal Neochordal Reconstruction of Tricuspid Valve for Perinatal Chordal Rupture Causing Severe Tricuspid Valve Regurgitation.

Background: Papillary muscle rupture in the perinatal period is a rare event that leads to severe mitral or tricuspid insufficiency due to a flail leaflet. Neonatal tricuspid chordal reconstruction for this condition is rarely reported. Early recognition and treatment have the potential to be lifesaving.

Pulmonary Valve Replacement in Repaired Tetralogy of Fallot Through Limited Left Anterolateral Thoracotomy: An Alternative to Repeat Sternotomy.

We report two patients with repaired tetralogy of Fallot who underwent pulmonary valve replacement through a limited left anterolateral thoracotomy. We describe the technique in detail. Both patients were at risk of cardiac injury during repeat sternotomy.

Left Superior Vena Cava Draining Into Left Atrium in Tetralogy of Fallot-Four Cases of a Rare Association.

Persistent left superior vena cava is a common congenital anomaly of the thoracic venous system. Left superior vena cava draining into left atrium is a malformation of sinus venosus and caval system. The anomaly may be a cause of unexplained hypoxia even in adults.

Surgical Options for Uhl's Anomaly.

Background: Uhl's anomaly is an extremely rare congenital heart defect characterized by a near total absence of the myocardium of the parietal wall of the right ventricle. Few reports of surgical management exist in literature. We present three patients with this anomaly who were managed with different surgical strategies.

Off-pump midline repair of coarctation of aorta when associated with intracardiac defects: an alternate approach for single-stage correction.

Objectives: Strategies for the optimal surgical management of coarctation of aorta with associated intracardiac defects continue to be debated upon. We describe a previously unreported surgical technique for the management of this combination of defects and present our early results.

Methods: Thirty-one patients (median age: 73 days and median weight: 3.

Large Right Ventricular Clot in Pulmonary Atresia With Intact Ventricular Septum: In Defense of Biventricular Approach.

Thrombus formation within the right ventricle (RV) in the setting of pulmonary atresia with intact ventricular septum (PAIVS) is not a very common occurrence and can be catastrophic. We present the case of a seven-month-old child with PAIVS and RV clot who successfully underwent biventricular repair. We discuss the interesting case and the rationale for management by means of biventricular repair over single ventricle repair when feasible in such a setting.

Supramitral ring: good prognosis in a subset of patients with congenital mitral stenosis.

Background: Management of congenital stenotic mitral valvular abnormalities remains an important therapeutic challenge. Supramitral ring constitutes a small but inadequately described subset that has a relatively good outcome with appropriate management.

Methods: Between 1996 and 2004, 15 patients with supramitral ring were managed in this institution.