Abstract:
:We report the case of a 30 year-old male with congenitally corrected transposition of the great arteries, atrial, and ventricular septal defects (VSD), and pulmonary stenosis. He previously underwent three palliative surgical procedures before undergoing intracardiac repair at age 20 with a left ventricular to pulmonary artery (LV-PA) conduit, VSD closure, and replacement of the systemic atrioventricular valve. A residual VSD was noted postoperatively. He did well for approximately 10 years when he started becoming more breathless with daily activities and was noted to have a resting room air oxygen saturation of 85%. Despite increased diuretic therapy he continued to deteriorate and was ultimately admitted to the hospital in florid right and left heart failure with recurrent atrial fibrillation. Catheterization revealed pulmonary hypertension (pulmonary artery pressure = 80/17 mm Hg), moderate conduit stenosis, severe pulmonic regurgitation, and oxygen saturation of 75%. Calculated shunt fraction (Qp : Qs) was 1.3:1. He was referred for surgical intervention, specifically, LV-PA conduit replacement, oversewing of the pulmonic valve, VSD closure, and pacemaker placement. Intraoperatively, the VSD could not be closed despite multiple attempts through various approaches. Therefore, perventricular VSD closure using two Amplatzer septal occluders (AGA Medical, Golden Valley, MN) was performed in the operating room with the chest open off cardiopulmonary bypass. Following deployment, the residual shunt was small and the inferior vena cava-to-pulmonary artery saturation step-up was only 4%. The left ventricular systolic pressure decreased to one half systemic. This case highlights the utility and efficacy of a hybrid approach in the treatment of complex congenital heart disease.
journal_name
Congenit Heart Disjournal_title
Congenital heart diseaseauthors
Aboulhosn J,Levi D,Sopher M,Johnson A,Child JS,Laks Hdoi
10.1111/j.1747-0803.2009.00339.xsubject
Has Abstractpub_date
2010-01-01 00:00:00pages
60-5issue
1eissn
1747-079Xissn
1747-0803pii
CHD339journal_volume
5pub_type
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abstract:OBJECTIVE:Determine the accuracy of echocardiography to diagnose coronary anatomy in transposition of the great arteries and to evaluate the effect of accuracy on surgical outcomes and changes in accuracy over time. DESIGN:Retrospective chart review of neonates admitted February 1999 to March 2013 with transposition. ...
journal_title:Congenital heart disease
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journal_title:Congenital heart disease
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journal_title:Congenital heart disease
pub_type: 杂志文章,meta分析
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更新日期:2015-05-01 00:00:00
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journal_title:Congenital heart disease
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journal_title:Congenital heart disease
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,多中心研究
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12249
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pub_type: 杂志文章,评审
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更新日期:2016-05-01 00:00:00
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journal_title:Congenital heart disease
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更新日期:2014-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-11-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2009.00280.x
更新日期:2009-05-01 00:00:00
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journal_title:Congenital heart disease
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doi:10.1111/j.1747-0803.2008.00209.x
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journal_title:Congenital heart disease
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2019-05-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/j.1747-0803.2011.00503.x
更新日期:2011-07-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 历史文章,杂志文章,评审
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更新日期:2010-05-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12277
更新日期:2016-01-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12616
更新日期:2018-07-01 00:00:00
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journal_title:Congenital heart disease
pub_type:
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更新日期:2017-01-01 00:00:00
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journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12241
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:The surgical management of adults with congenital heart disease (ACHD) offers a great challenge, with a large number of anomalies with complex pathophysiology necessitating specific treatments. Pre- and postoperative morbidity has been relatively high, and the influencing factors are not completely identified...
journal_title:Congenital heart disease
pub_type: 杂志文章
doi:10.1111/chd.12000
更新日期:2013-07-01 00:00:00