title: Periscope modification of right ventricle-to-pulmonary artery shunt in Norwood operation.
abstract: Given the purported hemodynamic advantages of the right ventricle (RV) to pulmonary artery (PA) conduit, many surgeons have adopted it as their preferred source of pulmonary blood flow during stage I palliation for hypoplastic left heart syndrome. Potential disadvantages of the RV-PA shunt include ventricular dysfunction, pseudoaneurysm formation, arrhythmia, and conduit obstruction, which can lead to a higher rate of unplanned reinterventions. The "dunk" technique was described to reduce the RV incision and proximal conduit obstruction; however, insertion of the ringed graft from the epicardium can be cumbersome and risk RV injury. We introduce a simplified, alternative method of placing the conduit, which we call the periscope technique, whereby the graft is withdrawn from within the RV cavity.
authors.affiliation: Department of Cardiothoracic Surgery, New York University School of Medicine, NYU Langone Medical Center, New York, New York.
authors.forename: Masaki
authors.initials: M
authors.lastname: Tsukashita
authors.affiliation: Department of Cardiothoracic Surgery, New York University School of Medicine, NYU Langone Medical Center, New York, New York. Electronic address: ralph.mosca@nyumc.org.
authors.forename: Ralph S
authors.initials: RS
authors.lastname: Mosca
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000601:surgery*; D058327:Norwood Procedures / Q000379:methods*; D019919:Prosthesis Implantation / Q000379:methods*; D011651:Pulmonary Artery / Q000601:surgery*; D013536:Suture Techniques