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J Thorac Cardiovasc Surg 2003;126:1650-1652
© 2003 The American Association for Thoracic Surgery

Brief communications

Closed correction of systemic semilunar valve insufficiency in the neonate

^a Divisions of Division of Pediatric Cardiothoracic Surgery, Children's Hospital of Pittsburgh, Pittsburgh, Pa, USA
^b Division of Pediatric Cardiology, Children's Hospital of Pittsburgh, Pittsburgh, Pa, USA

Received for publication April 15, 2003; accepted for publication April 29, 2003.

^* Address for reprints: Frank A. Pigula, MD, Pediatric Cardiothoracic Surgery, Room 2820, 2 Main, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213 USA
frank.pigula@chp.edu

The first 20% of the full text of this article appears below.

Systemic semilunar valve regurgitation can be a life-threatening hemodynamic lesion in the neonate with congenital heart disease. Although congenital aortic stenosis remains a vexing problem, a number of interventions have been designed to provide relief. Unfortunately, procedures designed to provide a more competent systemic semilunar valve in the neonate are limited. The reproducibility of reparative techniques might be unpredictable, and prosthetics are limited to small-caliber homografts; both approaches require cardiopulmonary bypass. We describe our experience with a surgical technique that treats systemic semilunar valve regurgitation in the neonate without the need for cardiopulmonary bypass.

Clinical summary

Patient 1 was 5-day-old boy given a diagnosis of truncus arteriosus (type IA) with interrupted aortic arch type A. The truncal valve was moderately stenotic (predicted gradient, 40 mm Hg) with moderate-to-severe insufficiency. At the time of the operation, a nodular, 4-leaflet truncal valve was found that was composed of 3 major and 1 minor leaflets. The minor leaflet was sutured to the adjacent leaflets in an attempt reduce the regurgitation.

Attempts at weaning from cardiopulmonary bypass met with low systemic blood . . . [Full Text of this Article]

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