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Ann Thorac Surg 2000;69:1603
© 2000 The Society of Thoracic Surgeons

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Invited commentary

^a Department of Surgery, University of Tennessee, 777 Washington Ave, Suite 215, Memphis, TN 38105 USA,

e-mail: dwatson{at}utmem.edu

Invited commentary

This innovative approach applies a well-known technique (Lecompte maneuver) to teralogy of Fallot with absent pulmonary valve in 4 infants. Current strategies for treatment of patients who also have considerable airway compromise secondary to severe PA dilatation have focused on how best to modify the normally positioned pulmonary arteries (PAs). PA plication, sometimes sequential, with or without pulmonary valve replacement, monocusp or otherwise, have been used [1]. Transecting the aorta to access the PA for adequate plication has been described [2]. None has suggested modifying the relationship of the ascending aorta and PA. This creative approach is refreshing and warrants consideration for treatment of these patients. It is simple and is easily replicated.

No data are presented to substantiate the hope that this approach eliminates compression of the tracheobronchial tree, short or long term. The anecdotal symptomatic improvement seen in the infants presented is encouraging. The Lecompte technique does potentially have this benefit and we look forward to studies showing the effect of this procedure on the airway. Our hope is that long-term follow up will also show no adverse sequelae for the superior vena cava and right PA. This approach deserves the attention of all congenital heart surgeons engaged in treating this abnormality.

References

1. McDonnell B.E., Raff G.W., Gaynor J.W., et al. Outcome after repair of tetralogy of Fallot with absent pulmonary valve. Ann Thorac Surg 1999;67:1391-1396.[Abstract/Free Full Text]
2. Conte S., Serraf A., Godart F., et al. Technique to repair tetralogy of Fallot with absent pulmonary valve. Ann Thorac Surg 1997;63:1489-1491.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Donald C. Watson Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Watson, D. C. Search for Related Content PubMed Articles by Watson, D. C.