title: Off-Pump Atrial Septectomy for Infants With Restrictive Atrial Septal Defect.
abstract: The management of some subsets of patients with an unsuccessful balloon atrial septostomy (BAS) and poor general condition is typically challenging. Our novel technique involves off-pump atrial septectomy using laparoscopic forceps guided by intraoperative direct pericardial echocardiography. The technique was first used in a case of tricuspid atresia in a patient in preshock and was then used in 2 more patients with hypoplastic left heart syndrome (HLHS) (age, 10-116 days; body weight, 2.4-3.7 kg). There were no operative complications of embolism or bleeding in our series. Our off-pump atrial septectomy technique is an effective approach in specific cases.
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan. Electronic address: taifuchigami@yahoo.co.jp.
authors.forename: Tai
authors.initials: T
authors.lastname: Fuchigami
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nishioka
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Akashige
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Higa
authors.affiliation: Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Nagata
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis / Q000601:surgery*; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male