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Ann Thorac Surg 2009;88:1348-1350. doi:10.1016/j.athoracsur.2009.02.088
© 2009 The Society of Thoracic Surgeons
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Yoshihiro Oshima
Masahiro Yoshida
Ayako Maruo
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Case Reports

Modified Primary Sutureless Repair of Total Anomalous Pulmonary Venous Connection in Heterotaxy

Yoshihiro Oshima, MD*, Masahiro Yoshida, MD, Ayako Maruo, MD, Chikashi Shimazu, MD, Tomonori Higuma, MD, Takeshi Inoue, MD

Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan

Accepted for publication February 20, 2009.

* Address correspondence to Dr Oshima, Department of Cardiovascular Surgery, Kobe Children's Hospital, 1-1-1 Takakura-dai, Suma-ku, Kobe, 654-0081, Japan (Email: ooshima_kch{at}hp.pref.hyogo.jp).

Early and late mortality remain high after palliative open heart surgery in low-weight neonates. In addition, the need for neonatal repair and the presence of pulmonary venous obstruction are risk factors for mortality in right isomerism. We describe a modified primary sutureless repair of infracardiac total anomalous pulmonary venous connection in a 1,600 g neonate with heterotaxy. Endarterectomy of intimal hyperplasia localized to the anastomotic site was required at bilateral bidirectional cavopulmonary connection 6 months after the initial repair. The patient underwent a successful fenestrated Fontan procedure using an extracardiac conduit at the age of 2 years.






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