Ryo Aeba, MD, Ryohei Yozu, MD

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Presentation transcript:

Right ventricle–pulmonary artery conduit with intake port in the Norwood procedure Ryo Aeba, MD, Ryohei Yozu, MD The Journal of Thoracic and Cardiovascular Surgery Volume 144, Issue 5, Pages 1260-1262 (November 2012) DOI: 10.1016/j.jtcvs.2012.06.022 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Back table preparation of the right ventricle to pulmonary artery conduit. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 1260-1262DOI: (10.1016/j.jtcvs.2012.06.022) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Small (<3 mm) stub wound is created in the ventricular wall, the location of which is guided by direct visualization from the ventricular cavity through the pulmonary valve, to exactly 5 mm below the pulmonary valve annulus. No myocardial resection is performed. A pair of forceps is negotiated through the stub wound to the outside of the opening of the pulmonary trunk and used to grasp the head of the Nelaton catheter (Covidien Japan, Fukuroi, Japan). B, The second 3-ringed conduit is positioned in the ventricular wall by withdrawing the Nelaton catheter. The traction suture on the other end is used for tugging in the opposite direction. The retaining sutures are cut to remove the Nelaton catheter. A few stay stitches are used to suture the epicardial incision. C, The conduit length is fine-tuned, and the cut end is slightly beveled. The proximal anastomosis of the right ventricle to pulmonary artery conduit is completed by suturing the 2 grafts and epicardial incision together. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 1260-1262DOI: (10.1016/j.jtcvs.2012.06.022) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Follow-up computed tomography angiocardiogram in a patient 10 months after surgery showing the widely open proximal anastomosis and no ventricular pseudoaneurysm formation. A, Multidetector volume-rendering image (front view). B, Multiplanar reconstruction image of the conduit lumen. EC, Extracardiac portion of the conduit; IM, intramural portion of the conduit; RV, right ventricle. The Journal of Thoracic and Cardiovascular Surgery 2012 144, 1260-1262DOI: (10.1016/j.jtcvs.2012.06.022) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions