Ex-utero intrapartum treatment as a novel bridging strategy to surgery in hypoplastic left heart syndrome with intact atrial septum—cross-circulation.

Slides:

Advertisements

Similar presentations

Uterine leiomyoma extension into right atrium: A case report

Advertisements

Max B. Mitchell, MD The Journal of Thoracic and Cardiovascular Surgery

Lindsay S. Rogers, MD, Amy L. Peterson, MD, J

The hybrid procedure for hypoplastic left heart syndrome: A procedure still looking for its place Carlos M. Mery, MD, MPH The Journal of Thoracic and.

An unusual case of severe aortic valve stenosis in an adult caused by aortic valve inflammatory myofibroblastic tumor Dong Zhao, MD, Chunsheng Wang,

Prediction and perinatal management of severely restrictive atrial septum in fetuses with critical left heart obstruction: Clinical experience using pulmonary.

Novel mechanism of mitral regurgitation after lung transplantation in a patient with scleroderma and pulmonary hypertension Christian A. Bermudez, MD,

Incomplete midline atrial chamber in a symptom-free adult: An enigma?

Nathaniel W. Taggart, MD, Joseph A. Dearani, MD, Donald J. Hagler, MD

A hybrid approach to stabilization and repair of obstructed total anomalous pulmonary venous connection in a critically ill newborn infant Jeffrey Meadows,

Ultrasound, endoscopy, and the recurrent nerve

Cardiac pheochromocytoma

B. Albat, MD, P. Messner-Pellenc, MD, A. Thévenet, MD

An alternate approach to valve replacement in patients with mitral stenosis and severely calcified annulus Sameh M. Said, MD, Hartzell V. Schaff, MD

Tomohiro Mizuno, MD, Richard D. Weisel, MD, Ren-Ke Li, MD, PhD

Bailout After Failed Biventricular Management of Critical Aortic Stenosis: Another Application of the Hybrid Approach Christian Pizarro, MD, Majeed A.

Biventricular assistance with the Jarvik FlowMaker: A case report

Form ever follows function

Christopher J. Petit, MD, Matthew J. Gillespie, MD, Matthew A

William M. DeCampli, MD, PhD

Charles C. Sticco, DO, Leonard O. Barrett, MD

Left ventricular inflow obstruction associated with persistent left superior vena cava and dilated coronary sinus Daniel J DiBardino, MD, Charles D Fraser,

Gananjay G. Salve, MCh, Shreepal A. Jain, MD, Bhavesh M

Intra-atrial rerouting by the posterior left atrial wall flap for total anomalous pulmonary venous return drainage into the coronary sinus in neonates

Timing for successful surgical management of heart block after placement of an Amplatzer occlusion device for secundum atrial septal defect repair Umang.

Primum non nocere when the treatment is worse than the disease

Zohair Al Halees, MD, Mahmoud M. Awad, MD, Frans Pieters, MD, Maie S

Successful cardiac transplant after Berlin Heart bridge in a single ventricle heart: Use of aortopulmonary shunt as a supplementary source of pulmonary.

Patent Foramen Ovale Complicating Heart Transplantation

Tricuspid regurgitation as a result of Chiari network attachment

Successful surgical treatment of hypoplastic left heart syndrome associated with a divided left atrium that was diagnosed intraoperatively Yuji Naito,

Myriad manifestations of myxoma

Hemoptysis as a rare presentation of cor triatriatum sinister

Michael G. Katz, MD, PhD, Anthony S

Cor triatriatum dexter: A rare cause of myocardial infarction and pulmonary embolism in a young adult Syed T. Hussain, MD, Kwabena Mawulawde, MD, Robert.

Acute myocardial infarction and limb ischemia as manifestation of nonbacterial thrombotic endocarditis Naoko Nagano, MD, Jean-François Morin, MD, FRCS,

Military surgeons just want to have fun

Ashok Muniappan, MD The Journal of Thoracic and Cardiovascular Surgery

The evolution of intraoperative support in lung transplantation: Cardiopulmonary bypass to extracorporeal membrane oxygenation P. Michael McFadden, MD,

Mitral valve replacement for inflow obstruction of left ventricular assist device in a child with restrictive cardiomyopathy Hari Tunuguntla, MD, Susan.

A randomized comparison of different ventilator strategies during thoracotomy for pulmonary resection Andrew D. Maslow, MD, Todd S. Stafford, MD, Kristopher.

Minimally invasive off-pump implantation of HeartMate 3 left ventricular assist device Diyar Saeed, MD, PhD, Stephan Sixt, MD, PhD, Alexander Albert,

Transient right ventricular dysfunction caused by retractor during lower hemisternotomy mitral valve repair in a patient with pectus excavatum Homare.

David L. Joyce, MD The Journal of Thoracic and Cardiovascular Surgery

Right ventricular failure from severe pulmonary hypertension after surgery for shone complex: Back to fetal physiology with reducting, atrioseptectomy,

Tae-Jin Yun, MD, PhD, Seung-Hyun Lee, MD, Jae-Kon Ko, MD, PhD

Pre-dicting post-ligation syndrome

Ductal stenting retrains the left ventricle in transposition of great arteries with intact ventricular septum Kothandam Sivakumar, MD, DM, Edwin Francis,

Regenerative therapy for hypoplastic left heart syndrome: First report of intraoperative intramyocardial injection of autologous umbilical-cord blood–derived.

Passing the torch The Journal of Thoracic and Cardiovascular Surgery

Preserving the V-engine shape of the left ventricle with Melody mitral valve replacement in small children Patrick O. Myers, MD The Journal of Thoracic.

Prioritizing quality improvement in pediatric cardiac surgery

A novel approach to the surgical correction of scimitar syndrome

Uterine leiomyoma extension into right atrium: A case report

Nonsurgical management of traumatic cardiac pseudoaneurysms

The Journal of Thoracic and Cardiovascular Surgery

Discussion The Journal of Thoracic and Cardiovascular Surgery

The future of cardiac surgery training: A survival guide

Anthony Azakie, MD, Natalie C. Johnson, BS, Petros V

Mechanical left ventricular unloading to prevent recurrent myocardial rupture Stephen Westaby, MS, PhD, Vipin Mehta, MD, Fidelma Flynn, MD, Neil Wilson,

Complete cavopulmonary shunt completion after in utero balloon atrial septoplasty for hypoplastic left heart syndrome Nicholas H. Von Bergen, MD, Harold.

Aneurysmal right coronary with fistula to the coronary sinus combined with severe stenosis of the left anterior descending artery: A snake on the heart

Why arch curvature affects arch resistance

First in line for robotic surgery: Would you want to know?

Preoperative PFTs: The answer is blowing in the wind

Lipomatous septal hypertrophy

Regression of Marked Myocardial Sinusoids Associated With Hypoplastic Left Heart Syndrome During Staged Fontan Approach Masamichi Ono, MD, Heidi Goerler,

Restrictive interatrial communication in hypoplastic left heart syndrome after modified Fontan repair Hassan W Nemeh, MD, Sushma Reddy, MD, Henry L Walters,

Giant right coronary artery aneurysm with a huge intramural thrombus

Bifid cardiac apex: A rare morphologic structure

Presentation transcript:

Ex-utero intrapartum treatment as a novel bridging strategy to surgery in hypoplastic left heart syndrome with intact atrial septum—cross-circulation revisited Ed Peng, MBBS, MRCSEd, MRCSGlasg, MD(Manch), FRCS(CTh), Lisa Howley, MD, Timothy M. Cromblehome, MD, James Jaggers, MD The Journal of Thoracic and Cardiovascular Surgery Volume 149, Issue 3, Pages 935-937 (March 2015) DOI: 10.1016/j.jtcvs.2014.11.053 Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Fetal echocardiogram preintervention: 4-chamber view showed fetal hypoplastic left heart syndrome with a thickened atrial septum bowing into the right atrium (denoted by asterisk [*]). B, Preintervention fetal echocardiogram showed a severely abnormal to-fro pulmonary venous Doppler pattern (forward-to-reverse velocity-time integral flow ratio of 1.7) without evidence of a decompressing vessel. Postintervention, there was a persistent abnormal to-fro flow pattern (forward-to-reverse velocity-time integral flow ratio of 1.6), with no demonstrable flow across the atrial septum. C, With the fetus partially delivered (pelvis and lower limbs remained in-utero), and the umbilical cord still intact, an incision was made in the midline for sternotomy. D, After cannulation of the ductus arteriosus and right atrium, CPB was initiated. The umbilical cord was then clamped and divided as shown. E, The diagram shows the layout of the fetal surgery operating room for the EXIT to CPB procedure (green: cardiac surgeons; red: fetal surgeons; yellow: anesthesia; orange: scrub nurses; gray: cardiologist; blue: operating table). F, Intraoperative photo showing interatrial stent in the right atrium (white arrow). LV, Left ventricle; LA, left atrium; RV, right ventricle; RA, right atrium; CPB, cardiopulmonary bypass. The Journal of Thoracic and Cardiovascular Surgery 2015 149, 935-937DOI: (10.1016/j.jtcvs.2014.11.053) Copyright © 2015 The American Association for Thoracic Surgery Terms and Conditions