Defect | Procedure | Details | Key Feature |
d-transposition (of the great vessels) and DORV with pulmonary stenosis | Damus-Kaye-Stansel Procedure | anastomosing the PA to the Ao
• VSD is repaired
• P. flow is reestablished by graft from subcl. artery or thoracic aorta | PA to the Ao |
d-transposition | Great Artery Switch | • The aorta and pulmonary artery are transected above the valve and coronary arteries
• The appropriate vessel is attached to the existing stump | transected above the coronary arteries |
Tricuspid Atresia/Tetralogy | Glenn Anastomosis | • Procedure used to divert flow from SVC to Right PA
• Classic Procedure attaches SVC to Right PA
• Bidirectional Procedure connects SVC to the MAIN PA for bidirectional flow | 2 procedures: Classic and Bidirectional |
Tetralogy of Fallot | Blalock-Taussig Anastomosis | Attaches Right Subclavian artery to Right Pulmonary Artery creating a permanent ductus arteriosus | Creates permanent DA |
Coarctation | Two types of repair:
1)End to end: Used in older children
2)Subclavian Flap Procedure:Used in young children/infants | 1)End to end:Area of narrowing is resected and the two ends are sewn together
2)Subclavian Flap Procedure: Subclavian Artery is ligated and sewn over coarct creating a live tissue graft | 2 types: End to end & Subclavian Flap |
ASD | Blalock-Hanlon Atrial Septostomy | Surgical creation of an ASD via a RIGHT THORACOTOMY | creation of an ASD |
• Persistent truncus arteriosus
• DORV
• D-transposition with VSD | Rastelli Procedure | Consists of:
• An external conduit from RV to pulmonary artery and
• An internal conduit from LV to aorta | external & internal conduits |
hypoplasia of aortic annulus or tunnel subaortic obstruction | Konno Procedure (Konno-Rastan) | • Widening of the LVOT with an incision that creates enlargement of the aortic root
• Incision of aortic annulus with AVR (aortic valve replacement) | Widening the LVOT |
d-transposition and DORV | Mustard/Senning Operation | Atrial septum is excised and atria are redirected:
• Systemic venous return to MV and LV
• Pulmonary venous return to TV and RV | IAS is excised |
mitral stenosis | Balloon Valvulotomy | Catheter used across ASD then placed in MV orifice. Balloon is inflated, splitting the valve along the commissures without causing traumatic damage to valve leaflet | balloon placed in MV |
hypoplastic left heart syndrome | Norwood Procedure | Done in 3 stages:
• Stage I: new aorta made using PA with Blalock-Taussig shunt and creation of ASD
• Stage II: Glenn anastomosis made. Blalock-Taussig shunt ligated and SVC is anastomosed to PA
• Stage III: IVC is diverted to the PA w/ atrial tunnel | 3 stages |
Tricuspid Atresia/Single Ventricle/Tetralogy of Fallot | Fontan Procedure | • Separates RV from rest of the heart with GoreTex baffle
• SVC and IVC flow into the RA. The right atrial appendage is attached to the PA and pulmonary artery is oversewn (sewn shunt)
• NOTE: Stage I uses Glenn Anastomosis first | GoreTex baffle |
Small ASD | single suture | • Most repairs done in the first 5 years of life
• Some require open heart; others are done via the cath lab
• Post-op echo – look for any flow across repair | first 5 years |
Larger ASD | Patch of pericardium or prosthetic material | • Most repairs done in the first 5 years of life
• Some require open heart; others are done via the cath lab
• Post-op echo – look for any flow across repair | first 5 years |