Surgical closed atrial septotomy under transesophageal guidance.
An infant with pulmonary atresia and intact ventricular septum is presented who, after initial patch reconstruction of the right ventricular outflow tract and bidirectional cavopulmonary anastomosis through a fifth median sternotomy, underwent an echocardiographically guided closed atrial septotomy, which resulted in marked long-term clinical improvement. The technique of intraoperative transesophageal echocardiography as used in the presented case represents an expanded role for this diagnostic modality in congenital cardiac surgery.
Division of Cardiothoracic Surgery, University of California at San Francisco 94143-0118, USA.
J A
JA
van Son
J C
JC
Vander Woude
W
W
Cheng
N H
NH
Silverman
M K
MK
Cahalan
F L
FL
Hanley
D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative; D018633:Pulmonary Atresia / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation