How to do itDouble-Barrel Right Ventricular Outflow: Tetralogy of Fallot Annulus Preservation Technique
Section snippets
Technique
After standard midline sternotomy and full heparinization, arterial and bicaval cannulation is performed. Cardiopulmonary bypass is then established with moderate hypothermia. The aorta is then clamped followed by a single dose of cold antegrade cardioplegia to achieve arrest. The main pulmonary artery (MPA) and infundibulum are opened and inspected. The MPA opening is extended into its branches as needed. A transatrial or transventricular approach to closing the ventricular septal defect (VSD)
Comment
This technique was originally conceptualized to address TOF repair in patients with an anomalous coronary artery crossing the infundibulum in a setting of limited availability of small-valved right ventricle–to–pulmonary artery conduits. For the initial patient, a 4-mm PTFE graft was placed as previously described as a “pop-off.” Remarkably 13 years later, although the graft had already occluded, the PVA had grown to normal diameter with no disfiguration of the infundibulum or MPA. Right
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Cited by (2)
Use of Indigenous Decellularized Valved Xenograft Conduit for Double-Barrel Right Ventricular Outflow Tract Reconstruction: Nine-Year Follow-Up
2016, World Journal for Pediatric and Congenital Heart Surgery