title: Strategy for ventricular septal defect closure after prior gastric pull-through.
abstract: A 9-year-old boy was referred with a perimembranous ventricular septal defect. At birth, he had undergone a right thoracotomy with ligation of a tracheoesophageal fistula, cervical esophagostomy, and feeding gastrostomy. At 2 years of age, he had gastric tube reconstruction with a pull-through retrosternally, anterior to the heart, and an end-to-end esophagogastric anastomosis. Via a right anterolateral thoracotomy through the previous scar, the entire gastric tube was mobilized away from the sternum to facilitate a median sternotomy. With the patient supine, a median sternotomy was performed without difficulty, and the ventricular septal defect was closed under cardiopulmonary bypass.
authors: Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia sivaprotoss77@yahoo.com.
authors: Sivakumar
authors: S
authors: Sivalingam
authors: Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia.
authors: Sivakumar
authors: S
authors: Krishnasamy
authors: Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia.
authors: Mohd Azhari
authors: MA
authors: Yakub
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002648:Child; D006345:Heart Septal Defects, Ventricular / Q000601:surgery*; D006801:Humans; D008297:Male; D056346:Sternotomy / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*
keywords: Abnormalities; digestive system abnormalities; esophageal atresia; heart septal defects; multiple; reoperation; ventricular