HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

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): Lars Nölke Nelson Alphonso Tom R. Karl Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nölke, L. Articles by Karl, T. R. Search for Related Content PubMed Articles by Nölke, L. Articles by Karl, T. R. Related Collections Related Article

Ann Thorac Surg 2007;83:727-728
© 2007 The Society of Thoracic Surgeons

---

Correspondence

Reply

^a Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland
^b Pediatric Heart Center, UCSF Children’s Hospital, 505 Parnassus Avenue, Room S-549, San Francisco, CA 94143-0118

(Email: larsnolk{at}indigo.ie; karlt{at}surgery.ucsf.edu).

To the Editor:

It is with interest that we read Tissot and colleagues’ 1] letter. They have re-stated the value of the Lecompte maneuver in congenital cardiac conditions associated with hypertensive dilatation of the pulmonary arteries resulting in bronchial compression; in our article we included such a patient with totally anomalous pulmonary venous drainage (APVS). Currently we selectively use reduction arterioplasty, and we certainly have seen cases in which a good result was achieved using the Lecompte maneuver in isolation. We would suggest that the Lecompte maneuver and pulmonary reduction arterioplasty should be considered as complementary procedures rather than mutually exclusive in APVS [2]. Although we accept that changing the mediastinal geometry (ie, the relationship between the great arteries and the bronchus, and the stretching of the pulmonary arteries) by means of the Lecompte maneuver is important, reduction of the pulmonary artery flow and pressure associated with complete repair in some patients is also important. In cases wherein the pulmonary artery diameter is several standard deviations greater than normal, an anterior reduction pulmonary arterioplasty adds little to the length or complexity of the procedure and should avoid a further period on cardiopulmonary bypass if the airway is found to be significantly compromised on a postoperative bronchoscopy.

	References

Top References

 

1. Tissot C, Aggoun Y, Beghetti M, da Cruz EM, Sierra J, Kalangos A. The Lecompte maneuver as an alternative to reduction pulmonary arterioplasty for relief of airway compression in absent pulmonary valve syndrome (letter) Ann Thorac Surg 2007;83:727.[Free Full Text]
2. Nölke L, Azakie A, Anagnostopoulos PV, Alphonso N, Karl TR. The Lecompte maneuver for relief of airway compression in absent pulmonary valve syndrome Ann Thorac Surg 2006;81:1802-1807.[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): Lars Nölke Nelson Alphonso Tom R. Karl Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nölke, L. Articles by Karl, T. R. Search for Related Content PubMed Articles by Nölke, L. Articles by Karl, T. R. Related Collections Related Article