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European Journal of Cardio-Thoracic Surgery, Vol 10, 809-811, Copyright © 1996 by European Association for Cardio-thoracic Surgery

ARTICLES

Acute aortic outflow obstruction by diminution of bulboventricular foramen size after volume unloading in univentricular physiology

JA Van Son and GS Haas
Division of Cardiothoracic Surgery, UCSF 94143-0118, USA.

A young child with [S, L, L] segmental anatomy, double-inlet left ventricle, transposition of the great arteries, rudimentary right ventricle, and mildly restrictive bulboventricular foramen is reported, in whom intraoperative temporary snaring of the modified Blalock- Taussig shunt resulted in instantaneous and dramatic volume contraction of the left ventricle, decrease in bulboventricular foramen size, and increase of the gradient across the latter from 10 mm Hg preoperatively to 50 mm Hg. A modified Damus-Stansel-Kaye procedure using autogenous aortic tissue resulted in unobstructed aortic outflow; in addition, a bidirectional cavopulmonary shunt was performed. The importance of early relief of actual or potential aortic outflow obstruction in hearts with restrictive bulboventricular foramen is emphasized.




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Copyright © 1996 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.