title: From atretic to perforated: a closer view of pulmonary atresia.
abstract: A 7-day-old male infant with membranous pulmonary atresia and intact ventricular septum (PA/IVS) underwent hybrid pulmonary valvotomy. Access was via median sternotomy guided by intra-operative epicardial ultrasonography. After puncturing the atretic pulmonary valve, a 6 mm Wanda balloon catheter was inflated to dilate the atretic valve. Adequate valve movement with antegrade flow was confirmed using real time epicardial echocardiography. Intra-operative epicardial ultrasonography is an effective tool for guiding PA/IVS during hybrid procedures. Epicardial echo imaging provides clear images with excellent quality, helps guide the hybrid operation, and prevents the need for the ionizing radiation of fluoroscopy.
authors.affiliation: Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ching-Hui
authors.initials: CH
authors.lastname: Shen
authors.forename: Chung-Chi
authors.initials: CC
authors.lastname: Wang
authors.forename: Hsien-Te
authors.initials: HT
authors.lastname: Fang
authors.forename: Ming-Chih
authors.initials: MC
authors.lastname: Lin
mesh_terms: D004452:Echocardiography / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D018633:Pulmonary Atresia / Q000000981:diagnostic imaging* / Q000601:surgery*; D011664:Pulmonary Valve / Q000000981:diagnostic imaging* / Q000601:surgery*; D011677:Punctures / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: epicardial; pulmonary atresia; ultrasonography