title: Hybrid ventricular decompression in pulmonary atresia with intact septum.
abstract: Initial palliation for pulmonary atresia with intact ventricular septum continues to evolve in the face of significant early and late morbidity. In patients with suitable anatomy, decompression of the right ventricle may be the first step in treatment. A hybrid approach to right ventricular decompression, combining surgery and interventional catheterization techniques is described. Direct access to the right ventricle through a subxiphoid incision with transventricular sheath placement is used to provide optimum catheter position for radiofrequency perforation of membranous pulmonary atresia followed by balloon dilation. The technique may address key limitations of the traditional surgical and interventional approaches.
authors.affiliation: Department of Cardiovascular Surgery, Miami Children's Hospital, The Congenital Heart Institute at Miami Children's Hospital, Miami, Florida 33155, USA. redmond111@aol.com
authors.forename: Redmond P
authors.initials: RP
authors.lastname: Burke
authors.forename: Robert L
authors.initials: RL
authors.lastname: Hannan
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Zabinsky
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Tirotta
authors.forename: Evan M
authors.initials: EM
authors.lastname: Zahn
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D002404:Catheterization; D019299:Decompression, Surgical; D006346:Heart Septum; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D018633:Pulmonary Atresia / Q000601:surgery*; D011664:Pulmonary Valve