Surgical repair of aorto-ventricular tunnel.

Détails

ID Serval
serval:BIB_65C0E99EA446
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Surgical repair of aorto-ventricular tunnel.
Périodique
Multimedia Manual of Cardiothoracic Surgery
Auteur⸱e⸱s
Mueller C., Dave H., Prêtre R.
ISSN
1813-9175 (Electronic)
ISSN-L
1813-9175
Statut éditorial
Publié
Date de publication
2012
Volume
2012
Pages
mms006
Langue
anglais
Résumé
This report presents a trans-aortic trans-infundibular double-patch repair of an aorto-left ventricular tunnel in a 17-day old male child. It reviews the literature on aorto-ventricular tunnels and debates strategic and surgical options available to correct these defects. Diagnosis of the tunnel in the case described herein was made prenatally. The child was presented with left ventricular dilatation with early and progressive signs of congestive heart failure. Decision for early surgical correction was made considering the quantum of regurgitant jet, diastolic backflow in the aorta and consequent left ventricular dilatation. After establishing cardiopulmonary bypass and arresting the heart, the aorta was transversely opened above the sinotubular junction and the tunnel identified. Aortic valve morphology and the coronary ostia not involved in the tunnel were carefully investigated. Through a transverse infundibulotomy, the thinned outer wall of the tunnel abutting the posterior wall of the infundibular septum was slit open vertically, thus clearly defining the aortic and the left ventricular orifices. The distal tunnel orifice, now presenting as a subaortic Ventricular septal defect (VSD), was closed using a xenopericardial patch and running polypropylene 7-0 stitches. The aortic end of the tunnel was closed in a similar fashion through the aortotomy, remaining clear of the right coronary artery and respecting the aortic valve geometry. The marsupialized wall of the tunnel as seen through the infundibulotomy was sutured with polypropylene stitches. The aortotomy and right ventriculotomy were closed. The postoperative course was uneventful. A follow-up echocardiography at 2 years showed a perfect outcome with no residual tunnel, no aortic stenosis and trivial aortic regurgitation.
Pubmed
Création de la notice
16/12/2014 19:09
Dernière modification de la notice
20/08/2019 15:21
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