RESUMO
Single-stage repair of complex cardiac abnormalities in high-risk neonates presents formidable challenges. The majority of hybrid strategies involving bilateral pulmonary artery banding (bPAB) with or without patent ductus arteriosus (PDA) stenting is described in the setting of hypoplastic left heart syndrome. We present a series of cases describing two-stage repair with initial palliative hybrid procedures involving bPAB with or without PDA stenting. This allows weight gain and stabilization of circulation before complete repair, provides good results, and may overcome risk factors associated with single-stage repair in neonates.
Assuntos
Anormalidades Múltiplas/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Permeabilidade do Canal Arterial/cirurgia , Cardiopatias Congênitas/cirurgia , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Artéria Pulmonar/cirurgia , Stents , Aorta Torácica/anormalidades , Evolução Fatal , Feminino , Seguimentos , Cardiopatias Congênitas/fisiopatologia , Implante de Prótese de Valva Cardíaca , Valvas Cardíacas/anormalidades , Valvas Cardíacas/cirurgia , Humanos , Síndrome do Coração Esquerdo Hipoplásico/fisiopatologia , Lactente , Recém-Nascido , Masculino , Cuidados Paliativos , Risco , Fatores de Risco , Transposição dos Grandes Vasos/cirurgia , Resultado do Tratamento , Aumento de PesoRESUMO
Atrioventricular septal defect (AVSD) is a common congenital cardiac surgical problem. Over the years, younger and smaller infants are having operations for this condition before irreversible cardio pulmonary changes occur. Traditionally a single or two patch techniques have been used to repair this defect. However, in the past two decades an innovative method of modified single patch technique popularized by Dr. Graham Nunn has gained worldwide popularity. This review discusses the origin, surgical principles, technique and outcomes of this method, popularly known as Nunn or Australian technique. Research comparing the modified single patch technique to classic single and double patch techniques has shown good preservation of atrioventricular valve function, no residual ventricular septal defect (VSDs), low incidence of left ventricular outflow obstruction, preserved conduction, easy reproducibility, and improved perioperative and long-term mortality.
RESUMO
We describe our experience with routine digital video recording of congenital heart operations. We currently use the "surgical eye," in which a small camera is mounted between the standard surgical loupe lenses. This technique has evolved during the years of experience with various other techniques. We believe this is a good method for accurate definition of intracardiac anatomy that closely resembles the surgeon's view. This arrangement is economical and invaluable in training. This method of recording has been used in more than 1,000 operations.