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J Thorac Cardiovasc Surg 2005;130:1464-1465
© 2005 The American Association for Thoracic Surgery

Brief Communication

A Fontan completion through stage I bilateral pulmonary artery banding for hypoplastic left heart syndrome

Department of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, Tsu, Japan.

Received for publication May 23, 2005; accepted for publication July 12, 2005.

^_* Address for reprints: Shin Takabayashi, MD, Department of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, 2-174, Edobashi, Tsu, Mie 514-8507, Japan. (Email: shin1111@clin.medic.mie-u.ac.jp).

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

Although the stage I Norwood procedure is usually the first choice for hypoplastic left heart syndrome (HLHS), a neonatal Norwood operation requires complicated postoperative management, such as delayed sternal closure or prolonged mechanical ventilation, and interstage deaths 1 after stage I Norwood procedures are an issue. Here we report less invasive Fontan completion through a novel strategy consisting of bilateral pulmonary artery (PA) banding for stage I palliation, followed by the Norwood procedure concomitantly performed with bidirectional Glenn shunt (BDG) for stage II palliation for HLHS.

Clinical Summary

A 7-day-old boy weighing 3.5 kg had a diagnosis of HLHS with aortic stenosis and mitral stenosis associated with mild tricuspid regurgitation (TR) without noncardiac anomalies. Immediately after admission, prostaglandin E₁ (PGE₁) was administered. Atrial septal defect (ASD) was not restrictive, and mechanical ventilation was not required before the operation. For stage I palliation, we performed bilateral PA banding through a median sternotomy with a right circumference of 10 mm and . . . [Full Text of this Article]

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