Biventricular repair in low-weight patient with interrupted aortic arch and aortic atresia.

BACKGROUND: Aortic atresia with ventricular septal defect is a very rare congenital cardiac anomaly, especially in combination with aortic arch interruption. It is always challenging to choose the optimal treatment tactics for such patients. One of the possible types of intervention is the Yasui procedure. There are only 19 reported cases in the literature of aortic atresia with interruption of the aortic arch type B or C, and not a single clinical case of type A. CASE PRESENTATION: The proband was a 2-day-old boy with diagnosis: aortic atresia with a ventricular septal defect and interruption of the aortic arch type B. The child underwent a Yasui procedure without serious postoperative complications and with good long-term result. CONCLUSIONS: The Yasui procedure in patients with aortic atresia and interrupted aortic arch can be performed with minimal complications, even in low-weight patients.

Perventricular device closure of ventricular septal defect using a video-assisted thoracoscopic approach.

We describe a new technique of perventricular closure of a perimembranous ventricular septal defect on a beating heart using transesophageal echocardiography guidance and video-assisted thoracoscopy. Ventricular septal defects were closed successfully, and no shunts, rhythm disorders, or valve incompetence developed during the short hospital stay. This procedure is safe and effective for selected patients. These early and mid-term results encourage further evaluation.

Surgical off-pump closure of perimembranous ventricular septal defects.

OBJECTIVE: To present our first experience in perventricular closure of ventricular septal defect, which is in our opinion, an important adjunct to current ventricular septal defect treatment options. BACKGROUND: Surgical closure under cardiopulmonary bypass is the treatment of choice for a perimembranous ventricular septal defect. Percutaneous techniques have technical limitations. To date, an off-pump approach and device deployment through the wall of the right ventricle is not widespread and has only been reported from China and Germany. We think this approach is promising in selected patients. METHODS: In July 2012, 7 pediatric patients with an isolated perimembranous ventricular septal defect (age range, 4 months to 8 years, mean 2.5 years, all female) with a body weight of 5 to 27 kg, mean 12.7 kg, underwent minimally invasive perventricular device closure. RESULTS: In all patients, the ventricular septal defect was occluded successfully based on transesophageal echocardiographic confirmation. There were no cases of occluder dislocation noted in the operating room or in the postoperative period. No residual shunts were observed. There was no transient or persistent rhythm disorder in any of the patients. All patients were discharged 4-5 days postoperatively, in excellent physical condition. CONCLUSIONS: The described off-pump approach showed excellent results. It offers such advantages as avoidance of the morbidity associated with cardiopulmonary bypass, significantly shorter hospital stay and therefore reduced costs, and a cosmetic advantage.