From Atretic to Perforated: A Closer View of Pulmonary Atresia

Authors

  • Ching-Hui Shen M.D., Ph.D.,

    1. Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan
    2. School of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Chung-Chi Wang M.D.,

    1. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
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  • Hsien-Te Fang M.D.,

    1. Department of Anesthesiology, Taichung Veterans General Hospital, Taichung, Taiwan
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  • Ming-Chih Lin M.D., Ph.D.

    Corresponding author
    1. School of Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
    • Address for correspondence and reprint requests: Ming-Chih Lin, M.D., Ph.D., Department of Pediatrics, Taichung Veterans General Hospital, 160, sec 3, Chung-Kang Road, Taichung 40705, Taiwan. Fax: 886-4-23741359;

      E-mail: mingchihlin@ntu.edu.tw

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Abstract

A 7-day-old male infant with membranous pulmonary atresia and intact ventricular septum (PA/IVS) underwent hybrid pulmonary valvotomy. Access was via median sternotomy guided by intra-operative epicardial ultrasonography. After puncturing the atretic pulmonary valve, a 6 mm Wanda balloon catheter was inflated to dilate the atretic valve. Adequate valve movement with antegrade flow was confirmed using real time epicardial echocardiography. Intra-operative epicardial ultrasonography is an effective tool for guiding PA/IVS during hybrid procedures. Epicardial echo imaging provides clear images with excellent quality, helps guide the hybrid operation, and prevents the need for the ionizing radiation of fluoroscopy.

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