Outcomes of palliative right ventricle to pulmonary artery connection for pulmonary atresia with ventricular septal defect.

Objectives: To determine the early, intermediate and long-term outcomes of pulmonary atresia with ventricular septal defect (PA/VSD) Types I, II and III initially palliated by a right ventricle to pulmonary artery (RVPA) connection.

Methods: We performed a retrospective study from 2000 to 2014 that included 109 patients with PA/VSD who had undergone an RVPA connection (tetralogy of Fallot and PA/VSD Type IV excluded). The end-points of this strategy were adequate pulmonary artery tree post-palliation, second palliation, biventricular repair, right ventricular pressure post-biventricular repair and late reoperation.

Dilatable pulmonary artery band: Safety and efficacy of balloon dilatation.

Objectives: Review early and midterm results of dilatable pulmonary artery band (PAB).

Background: PAB is performed in various conditions: as a transient stage before ventricular septal defect (VSD) closure, as a palliative procedure for multiple VSD or to prepare the left ventricle (LV) before switch or double switch operations in transposition of the great artery (TGA) or congenitally corrected transposition of great arteries (CCTGA).

Methods: All children with dilatation of PAB were reviewed.

Aortic root replacement in children: a word of caution about valve-sparing procedures.

Objective: Evaluate the results of various surgical procedures used for aortic root replacement in children with aortic root aneurysm.

Methods: Between 1986 and 2007, 23 children (less than 16 years of age, mean age: 8.1+/-5.

Myocardial revascularization in infants and children by means of coronary artery proximal patch arterioplasty or bypass grafting: a single-institution experience.

Objective: We sought to evaluate midterm functional and anatomic results after coronary artery surgical arterioplasty or bypass grafting in infants and children.

Methods: Data concerning all consecutive patients operated on for myocardial revascularization in our institution between 1992 and 2004 were retrospectively analyzed.

Results: Twenty-five patients (mean age, 5.

Arterial aneurysms and tuberous sclerosis: a classic but little known association.

Tuberous sclerosis is a rare autosomal dominant syndrome in which aortic aneurysm is a classic but little known cause of sudden death. We report a 20-month-old boy with tuberous sclerosis and iliofemoral arterial aneurysms. This case highlights the importance of systematic screening for such vascular complications.

The Ross procedure in infants and young children.

Background: This study reviews our experience with the Ross procedure in infants and young children.

Methods: From September 1993 to September 2004, 52 children less than 15 years of age underwent a Ross procedure. The patients ranged in age from 4 days to 15 years old (median, 5 years).

Orthotopic heart transplantation for congenital heart defects: situs inversus.

Although rare, visceroatrial situs inversus is not exceptional in patients with complex congenital heart defects. Achieving orthotopic heart transplantation using a graft harvested in a donor with situs solitus is surgically demanding. Technical problems can, however, be overcome by adequate harvesting of donor heart and by the use of innovative reimplantation techniques.

Orthotopic heart transplantation for congenital heart defects: anomalies of the systemic venous return.

Anomalies of the systemic venous return are frequently associated with other congenital heart defects. Some anomalies do not complicate really orthotopic heart transplantation (such as azygos continuation of the inferior vena cava). Other anomalies raise more difficulties; the most frequent one is persistent left superior vena cava draining into either the coronary sinus or the left atrium.

Culture-negative pericarditis caused by Neisseria meningitidis serogroup C.

We describe a case of primary purulent culture-negative pericarditis caused by Neisseria meningitidis serogroup C occurring in an 8-month-old previously healthy boy, which was detected in pericardial fluid by broad-spectrum PCR amplification.

[Cardiac retransplantation in childhood. Questions and answers].

Cardiac transplantation in childhood remains a long-term palliative procedure and it is probable that an increasing number of patients undergoing this procedure in childhood will require a new transplant one day. Coronary artery disease of the transplanted heart is the main indication. The results (in terms of survival and morbidity) in the literature and in the authors' experience are encouraging and justify the indication for retransplantation in cases of severe coronary disease of the transplanted heart.

Histomorphometric analysis of pulmonary vessels in single ventricle for better selection of patients for the Fontan operation.

Objective: In cases of single-ventricle physiology, the Fontan procedure often fails even when the usual selection criteria are strictly respected. We analyzed specimens from intraoperative open lung biopsies performed on 40 patients with single-ventricle physiology who were considered to be good candidates for the Fontan procedure. Histomorphometric study was performed to determine histologic factors predictive of failure of the Fontan procedure.

Results of the arterial switch operation in neonates with transposed great arteries.

Background: The arterial switch operation is judged the best palliative operation for neonates with transposed great arteries. We aimed to assess the value of analysing a large series of unselected cases by this technically demanding operation and formulate a realistic prognosis.

Methods: We reviewed all 432 neonates (mean age at operation 7 days, mean weight 3.

Results of the Lecompte procedure in malposition of the great arteries and pulmonary obstruction.

Objective: Assessment of the Lecompte procedure, our repair method of choice in malposition of the great arteries with pulmonary stenosis.

Methods: A retrospective analysis of 42 patients (median age at operation, 1.4 years) operated on between 1986 and 1999 for various forms of great artery malposition, ventricular septal defect, and pulmonary stenosis.

Bi-directional cavopulmonary shunt: is accessory pulsatile flow, good or bad?

Objective: Evaluation of the effect and long-term outcome of accessory pulsatile blood flow versus classical bi-directional cavopulmonary connection (BCPC).

Methods: Retrospective review of the medical and surgical records.

Results: Two-hundred and five patients (119 boys, 86 girls) underwent BCPC from 1990 to 1996.

A new strategy for the surgical treatment of aortic coarctation associated with ventricular septal defect in infants using an absorbable pulmonary artery band.

Objectives: We propose a new strategy using coarctation repair together with a polidioxanone absorbable pulmonary artery banding to limit operative risk and to spare infants with aortic coarctation subsequent operations.

Background: The alternative for the surgical management of aortic coarctation associated with ventricular septal defect (VSD) is single-stage repair versus coarctation repair with or without banding of the pulmonary artery.

Methods: Eleven infants (mean weight 2,560 +/- 1,750 g, range 1,320 to 3,800 g) underwent a coarctation repair with a polydioxanone banding.

Abdominal aortic aneurysm in a child with tuberous sclerosis.

Tuberous sclerosis is known to be associated with neurologic, renal and cardiac lesions. We report a case involving a child with tuberous sclerosis who developed infrarenal abdominal aortic aneurysm. Surgical therapy was successful.

Neonatal arterial switch operation: coronary artery patterns and coronary events.

Objective: To determine the incidence of coronary events following neonatal arterial switch and to identify potential risk factors for death and coronary events.

Methods: The total experience (236 consecutive arterial switch operations) of one surgeon was studied. Associated procedures included ventricular septal defect closure in 37 patients (16%) and aortic arch repair in 14 patients (6%)).

Ten-year experience with surgical treatment of partial atrioventricular septal defect: risk factors in the early postoperative period.

Partial atrioventricular septal defects are electively repaired with good results. However, recent reports suggest that such repair is potentially a high-risk surgical procedure. Our aim was to determine the risk factors of adverse outcome early after surgical treatment of atrioventricular septal defects in our hospital.

Donor-recipient size matching in pediatric heart transplantation: a word of caution about small grafts.

Background: The increased shortage of donor organs led centers to extend the conventional donor criteria, particularly regarding donor-recipient size mismatching. Little information is available in the pediatric age group.

Methods: Between December 1987 and May 1994, 73 pediatric orthotopic heart transplantations were performed.

[Risk factors of coronary graft disease following heart transplantation in children].

Coronary disease after cardiac transplantation is a major medium and long-term complication in adult patients. In childhood, this is reputed to be rare and, therefore, the authors undertook a study to evaluate its incidence and the role of potential risk factors in this age group. The study included 30 children followed up at least one year after cardiac transplantation and investigated by at least one selective coronary angiography after the first postoperative year.

Surgical treatment of multiple ventricular septal defects using a biologic glue.

The closure of multiple ventricular septal defects remains a surgical challenge. Mortality and morbidity are high. Left ventricular incision and multiple patches or stitches impair septal motion and function.

Arterial switch operation: a new technique of coronary transfer.

A successful outcome after arterial switch operation (ASO) for transposition of the great arteries (TGA) depends in large part on the adequacy of transfer of the coronary arteries to the neoaorta. The present paper describes a new technique of coronary transfer which was used in 43 patients: 28 neonates with TGA and intact septum (with coarctation in one), 10 neonates with TGA and ventricular septal defect (with coarctation in one), 2 children undergoing ASO after failed Senning operation and 3 patients with complex TGA. A standardized uniform technique of coronary transfer was used; this technique involved reimplantation of the two coronary ostia side by side after excision of a single button of neoaortic wall.

Pediatric cardiac transplantation for congenital heart defects: surgical considerations and results.

Among 54 children who underwent 55 heart transplantations, 24 (44%) (mean age, 4.9 +/- 4.8 years; range, 9 days to 18 years) had congenital defects with the following diagnoses: single-ventricle variants (6), hypoplastic left heart syndrome variants (5), transposition complex (6), and miscellaneous defects (7).