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  • Title: Everting closure for interrupted aortic arch, ventricular septal defect, and severe subaortic stenosis.
    Author: Watanabe T, Tajima K, Sakai Y, Shimomura T, Song MH, Suenaga Y, Murase M.
    Journal: Thorac Cardiovasc Surg; 1998 Feb; 46(1):33-6. PubMed ID: 9554046.
    Abstract:
    Interrupted aortic arch with ventricular septal defect in the neonate is sometimes complicated by severe subaortic stenosis from posterior deviation of the infundibular septum. We have developed a novel approach to the treatment of this condition. The infundibular septum is penetrated from the right-ventricular side to the left-ventricular outflow tract. It is compressed with patch fixation. The lower margin of the infundibular septum is everted. Three consecutive neonates were treated. The smallest diameters of the left-ventricular outflow tract were 3,4, and 2.5 mm. All patients survived the operation and were discharged from the hospital. They remained well 2 to 7 years after the repair and were in normal sinus rhythm without a left bundle branch block or any significant pressure gradient between the upper and lower extremities. Follow-up two-dimensional and Doppler echocardiography demonstrated no residual shunt, no left-ventricular outflow-tract pressure gradient, and no aortic regurgitation. This technique provides effective widening of the left-ventricular outflow tract, and is more safely and easily performed than conventional methods.
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