Modified Damus-Kaye-Stansel Anastomosis to Prevent Coronary Obstruction Between the Great Arteries.

The conventional Damus-Kaye-Stansel procedure may cause coronary artery compression when the coronary arteries are situated between the great arteries. We have performed a modified Damus-Kaye-Stansel procedure utilizing a "flap-bridging technique," in which an inverted U-shaped flap incised from the aorta is bridged to the main pulmonary trunk, creating sufficient space between the great arteries, in an 8-month-old boy who was a Fontan candidate with congenitally corrected transposition of the great arteries. This modified approach yielded favorable outcomes without coronary events and can effectively prevent coronary obstruction in cases where the coronary arteries run between the great arteries.

Configuration of the neoaortic root after chimney reconstruction in the Norwood procedure.

Objectives: After staged reconstruction for hypoplastic left heart syndrome, the neoaortic root tends to dilate, and the incidence of significant neoaortic valve insufficiency increases with time. This study aimed to evaluate the mid-term outcomes of the neoaortic root geometries and valve function after chimney reconstruction in the Norwood procedure.

Methods: Between 2013 and 2021, 20 consecutive patients who underwent chimney reconstruction during the Norwood procedure for hypoplastic left heart syndrome and its variants in our institution were enrolled.

Estimation of Basin-scale turbulence distribution in the North Pacific Ocean using CTD-attached thermistor measurements.

A recently developed technique for microstructure measurement based on a fast-response thermistor mounted on a conductivity-temperature-depth equipment was used on eight cruises to obtain 438 profiles. Thus, the spatial distribution of turbulent dissipation rates across the North Pacific sea floor was illustrated, and was found out to be related to results obtained using tide-induced energy dissipation and density stratification. The observed turbulence distribution was then compared with the dissipation rate based on a high-resolution numerical ocean model with tidal forcing, and discrepancies and similarities between the observed and modelled distributions were described.