Document Detail

Single ventricle (single- or double-inlet) complicated by subaortic stenosis: surgical options in infancy.
MedLine Citation:
PMID:  4039129     Owner:  NLM     Status:  MEDLINE    
Intracardiac obstruction to the systemic circulation can develop in patients with many forms of congenital heart disease. When transposition of the great arteries accompanies tricuspid atresia, narrowing of the ventricular septal defect (VSD) leads to subaortic stenosis. In a similar fashion, a restrictive bulboventricular foramen compromises systemic arterial outflow in patients who have single left ventricle with subaortic outflow chamber. The same effect can be seen in VSD closure in mitral atresia with normally related great vessels. Although some forms of single ventricle can be treated by ventricular septation, the modified Fontan procedure can be more generally applied to this entity. Pulmonary vascular resistance must be low, however, which excludes the application of the Fontan principle in infants. While pulmonary artery banding may protect the lungs from the development of excessive pulmonary vascular resistance, it may also accelerate the development of subaortic obstruction. We have successfully applied the Norwood operation, as described for hypoplastic left heart syndrome, to palliate subaortic stenosis due to restrictive VSD in 3 infants with single ventricle or atrioventricular valve atresia. Consideration should be given to a primary Norwood procedure in infants with single ventricle in whom subaortic stenosis is likely to develop. Patients who do receive pulmonary artery bands should be followed closely for the development of subaortic stenosis and should undergo an early, physiologically corrective operation if it occurs.
R A Jonas; A R Castaneda; P Lang
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  39     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1985 Apr 
Date Detail:
Created Date:  1985-05-02     Completed Date:  1985-05-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  361-6     Citation Subset:  AIM; IM    
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MeSH Terms
Aortic Stenosis, Subvalvular / etiology,  surgery*
Cardiomyopathy, Hypertrophic / surgery*
Ductus Arteriosus, Patent / complications
Heart Septal Defects, Ventricular / complications*
Infant, Newborn
Mitral Valve / abnormalities
Pulmonary Artery / surgery
Transposition of Great Vessels / complications
Tricuspid Valve / abnormalities

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

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