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Tricuspid Atresia IIc With a Vascular Ring: Novel Approach for Fontan Completion  Shinya Yokoyama, MD, Kozo Kaneda, MD, PhD, Shigeo Nagasaka, MD, PhD,

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Presentation on theme: "Tricuspid Atresia IIc With a Vascular Ring: Novel Approach for Fontan Completion  Shinya Yokoyama, MD, Kozo Kaneda, MD, PhD, Shigeo Nagasaka, MD, PhD,"— Presentation transcript:

1 Tricuspid Atresia IIc With a Vascular Ring: Novel Approach for Fontan Completion 
Shinya Yokoyama, MD, Kozo Kaneda, MD, PhD, Shigeo Nagasaka, MD, PhD, Tomofumi Taki, MD, Yuichi Yoshida, MD, Masafumi Kudo, MD, Akira Marui, MD, PhD, Noboru Nishiwaki, MD, PhD  The Annals of Thoracic Surgery  Volume 101, Issue 3, Pages (March 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A and B) Three-dimensional computed tomography before first palliation shows a vascular ring consisting of the right aortic arch, an aberrant left subclavian artery, and a left patent ductus arteriosus ligament. (C) White arrow indicates the tracheal stenosis resulting from compression caused by the reconstructed neoaorta. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Surgical technique. (A) Appearance after first palliation. (B) Neo–ascending aorta is transected just above the Damus-Kaye-Stansel (DKS) anastomosis. (C) Craniocaudal view of a transected neoaorta. Posterior wall of the former main pulmonary artery (PA) was cut off into a round shape. (D) Cut edge was sutured longitudinally. (E) Right superior vena cava (SVC) was anastomosed to left PA in an end-to-end fashion using continuous sutures, and right PA and right SVC were anastomosed in an end-to-side fashion using continuous sutures. (∗The broken line in B and C is an incision line.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Angiography at 14 months after Fontan completion. There was no stenosis in Fontan system and fenestration closed naturally. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

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