Contained rupture of right ventricular outflow tract after Rastelli-type operation.

This report describes a 3-year-old infant with post-operative mediastinitis complicated by a contained rupture of the right ventricle. A contained rupture is recognised as the huge pulsating prominence of the anterior chest wall. CT confirmed blood communication between the right ventricular outflow tract and the cavity surrounded by the pectoral major musculocutaneous flap.

Long-term results after palliative intra-cardiac repair for tetralogy of Fallot and diminutive pulmonary arteries.

Background: In patients with tetralogy of Fallot with the diminutive pulmonary arteries, we sometimes have to give up the complete intra-cardiac repair due to insufficient growth of the pulmonary arteries. We have carried out palliative intra-cardiac repair using a fenestrated patch.

Methods: Of all 202 patients with tetralogy of Fallot in our centre since 1996, five patients (2.

Successful Truncal Valve Replacement After Truncal Valve Repairs.

The surgical management of severe truncal valvular dysfunction is still challenging in neonates with persistent truncus arteriosus. This report describes a 14-day-old neonate with severe truncal valve insufficiency successfully undergoing truncal valve repairs, and followed by valve replacement at the age of 4 years. The truncal valve was quadricuspid with two large and two small leaflets, and all leaflets had severe dysplastic and myxomatous changes.

Cardiac surgical strategy for extremely low-birthweight infants with pulmonary overcirculation.

Objectives: This study aimed to review the clinical outcomes of staged cardiac surgery in extremely low-birthweight infants with congenital heart disease and pulmonary overcirculation.

Methods: Six extremely low-birthweight infants with congenital heart disease and pulmonary overcirculation underwent staged cardiac surgery between 2005 and 2017. The median birthweight was 895 g (range 620-990 g), and the median gestational age was 28 weeks (range 23-31 weeks).

Efficacy of Damus-Kaye-Stansel procedure in patients with univentricular heart associated with ventriculo-arterial discordance and excessive pulmonary blood flow.

Pulmonary artery banding (PAB) and ventriculo-arterial discordance (VAD) were reported to be risk factors of subaortic stenosis in univentricular heart. The aim of this study was to evaluate efficacy of Damus-Kaye-Stansel (DKS) anastomosis. Of all 89 patients undergoing total cavo-pulmonary connection (TCPC) in our center since April 1996, 38 had VAD with high pulmonary blood flow, and had received PAB.

Staged Starnes Operation Preserving Patent Ductus Arteriosus for Neonates with Ebstein's Anomaly and Pulmonary Atresia.

We herein reported 2 successful neonates with Ebstein's anomaly and small pulmonary arteries undergoing Starnes operation preserving the patent ductus arteriosus. Subsequent Blalock-Taussig shunt was carried out 1 or 2 months after the first surgery. One case had already undergone a successful Fontan operation, and the other had a successful bidirectional Glenn shunt so far.

Bidirectional Glenn shunt with concomitant placement of extra-cardiac graft - preparatory procedure for the future total cavo-pulmonary connection.

We herein present bidirectional Glenn shunt and concomitant placement of extra-cardiac graft with an advantage of preparation for a later extra-cardiac total cavo-pulmonary connection, which was successfully performed for seven children with a univentricular heart.

Outcomes of surgical treatment of infants with hypoplastic left heart syndrome: an institutional experience 1983-2004.

Aim: To determine outcomes of surgical treatment of infants with hypoplastic left heart syndrome (HLHS).

Methods: Retrospective analysis of medical records of infants with HLHS.

Results: 129 of 206 (63%) infants with HLHS were managed surgically over the period 1983-2004.

Surgical strategy for the bicuspid aortic valve: tricuspidization with cusp extension versus pulmonary autograft.

Objective: The congenitally bicuspid aortic valve is the most common etiologic factor associated with clinically significant aortic stenosis and/or regurgitation in pediatric patients. Beyond infancy, surgical intervention typically involves valve repair with cusp thinning and commissurotomy or valve replacement, primarily with pulmonary autograft in the current era. An aortic valve repair technique using tricuspidization with cusp extension was introduced in 1999.

Evaluation of the portal vein after duodenoduodenostomy for congenital duodenal stenosis associated with the preduodenal superior mesenteric vein, situs inversus, polysplenia, and malrotation.

A male infant weighting 2970 g with total situs inversus, polysplenia, malrotation, duodenal stenosis, and complex cardiac anomalies, was admitted to our hospital. At 4 days of age, he underwent surgery that revealed a blood vessel passing over the duodenum from the mesenterium to the porta hepatis. A loose overbridging duodenoduodenostomy was performed to prevent compression of the vessel.

Extracardiac Fontan procedure bridging the vertebra for apico-caval juxtaposition.

For 5 patients with univentricular heart associated with apico-caval juxtaposition, an extracardiac Fontan procedure was carried out using an artificial graft bridging the vertebra to avoid graft compression by the vertebra and the ventricle. For 2 patients representing nonconfluency between the inferior caval vein and the hepatic vein, a hand-made, shoe-tree graft was used. Postoperatively all patients are doing well without a stenotic venous pathway.

Impact of the off-pump Fontan procedure on complement activation and cytokine generation.

Background: To investigate whether the Fontan procedure in an off-pump fashion is less invasive in terms of the systemic inflammatory reaction.

Methods: Plasma levels of complement and cytokines were measured during and after the Fontan procedure in consecutive 38 patients. Of these, 16 underwent the extracardiac method without use of cardiopulmonary bypass (off-pump group), while the machine was used in the remaining 22 because of intracardiac maneuvers concomitantly needed (CPB group).