[Concomitant mitral valvuloplasty and fenestrated total cavopulmonary connection: a case report].
A seven-year-old boy with tricuspid atresia successfully underwent a fenestrated total cavopulmonary connection and mitral valvuloplasty. Preoperative cardiac catheterization showed a mean pulmonary artery pressure of 16 mmHg. Pulmonary arteriography showed poor development of the branches (PA index: 180). Echocardiography revealed mild to moderate mitral valve incompetence due to prolapse of anterior leaflet. Mitral valve was exposed through the trans-septal approach. The excess chorda length was tucked into a longitudinal split in the top of the posterior papillary muscle. Then wedge resection of the redundant segment of the anterior leaflet and bilateral annuloplasty were performed. Finally, a total extracardiac cavopulmonary anastomosis with a 6 mm fenestration was completed. Postoperative clinical course was uneventful, and he is doing well with no recurrence of mitral incompetence 1 year after the operation.
Yoshimura
N
N
Department of Cardiothoracic Surgery, Kobe Children's Hospital, Japan.
Yamaguchi
M
M
Ohshima
Y
Y
Toyoda
Y
Y
Oka
S
S
Ohtaki
Y
Y
Murakami
H
H
Ogawa
K
K
Tei
T
T
Kuroe
K
K
Kido
S
S
D002648:Child; D018729:Fontan Procedure; D018610:Heart Bypass, Right / Q000379:methods*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*