Creation of a one-way interatrial communication in the treatment of critical pulmonary stenosis with intact ventricular septum: a case report.
BACKGROUND
In biventricular repair of pulmonary outflow tract obstruction with intact ventricular septum, the right ventricle is loaded with total pulmonary blood flow acutely as the right-to-left shunt is abolished by closure of the atrial septal defect (ASD).


METHODS
We designed a one-way interatrial communication by creation of an atrial septal flap to reduce the excessive volume load of the right ventricle.


RESULTS
This procedure was successfully performed in a 3-year-old girl undergoing definitive biventricular repair for critical pulmonary stenosis associated with tricuspid stenosis and a small right ventricle.


CONCLUSIONS
We believe that creation of a one-way interatrial communication might be a good alternative to adjustable ASD and/or bidirectional Glenn shunt in biventricular repair of critical pulmonary stenosis or pulmonary atresia with intact ventricular septum.
Lin
S F
SF
Department of Surgery, National Taiwan University Hospital, Taipei.
Chiu
I S
IS
Hsu
R B
RB
D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000601:surgery; D006801:Humans; D011666:Pulmonary Valve Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*