Document Detail


Hybrid approach as bridge to biventricular repair in a neonate with critical aortic stenosis and borderline left ventricle.
MedLine Citation:
PMID:  19324570     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A newborn presented with severe aortic valve stenosis and a borderline hypoplastic left ventricle due to disproportionate left ventricular hypertrophy (maternal diabetes). The aortic valve was balloon dilated and the infant tolerated a biventricular circulation. However, severe retrograde pulmonary hypertension and mitral regurgitation developed, indicating that biventricular circulation was not possible at that stage. A hybrid approach with ductal stenting, atrial septostomy and bilateral dilatable pulmonary artery band placement was followed on day 25. This allowed the left ventricle several months to adapt to lower pressure and normoglycemic conditions. At re-evaluation after 8 months biventricular repair appeared possible: the ductus was closed with Amplatzer occluders and the pulmonary artery bands were opened up with bilateral balloon angioplasty of the dilatable bands. At the age of 3 years, the infant is doing well with a biventricular circulation and normal pulmonary artery pressure. The hybrid approach allowed adequate time (months) for careful consideration and acted as a bridge to biventricular repair in this infant.
Authors:
Stephen C Brown; Derize Boshoff; Benedicte Eyskens; Marc Gewillig
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-03-25
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  35     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1080-2     Citation Subset:  IM    
Affiliation:
Pediatric Cardiology, University of the Free State, Bloemfontein, South Africa.
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MeSH Terms
Descriptor/Qualifier:
Aortic Valve Stenosis / therapy*
Balloon Dilatation
Combined Modality Therapy
Ductus Arteriosus, Patent / surgery
Follow-Up Studies
Humans
Hypertension, Pulmonary / therapy
Hypoplastic Left Heart Syndrome / surgery,  therapy*,  ultrasonography
Infant, Newborn
Male

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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