| Single ventricle (single- or double-inlet) complicated by subaortic stenosis: surgical options in infancy. | |
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MedLine Citation:
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PMID: 4039129 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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R A Jonas; A R Castaneda; P Lang |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 39 ISSN: 0003-4975 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 1985 Apr |
Date Detail:
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Created Date: 1985-05-02 Completed Date: 1985-05-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 361-6 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aortic Stenosis, Subvalvular
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etiology,
surgery* Cardiomyopathy, Hypertrophic / surgery* Ductus Arteriosus, Patent / complications Heart Septal Defects, Ventricular / complications* Humans Infant, Newborn Male Methods 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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