Mediastinoscopy is the ‘gold standard’ method for determining the presence of nodal metastases in the mediastinum. Generally performed as an outpatient surgical procedure, it is associated with a low rate of serious adverse effects (<1%) and the procedure is highly accurate, with false negative rates reported to be between 6% and 9%.
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Expert Techniques
March 21, 2013
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly that is one of the most common causes of myocardial ischemia and infarction in children. If untreated, it results in a mortality rate of up to 90% within the first year of life. In the current era, establishment of a two coronary artery system is considered the goal for repair of ALCAPA.
March 21, 2013
The Aortic Translocation procedure was introduced for the management of patients with complex transposition of the great arteries (TGA) with a ventricular septal defect (VSD) and pulmonary stenosis (PS). The technique has proven especially useful in the subset of patients with anatomic variables that complicate the performance of a Rastelli repair.
March 21, 2013
The completion Fontan operation is, as the name implies, the final stage of palliation for patients who have had previous surgery to address various types of single ventricle congenital heart disease.
March 21, 2013
The superior cavopulmonary anastomosis is the first of two operations used in a staged Fontan approach for definitive palliation of functionally single ventricle hearts.
March 21, 2013
Brom’s three-patch aortoplasty is indicated for the repair of supravalvar aortic stenosis, which can occur as an isolated defect or as a part of Williams syndrom. This syndrome is characterized by supravalvar aortic stenosis, elfin craniofacial features, peripheral pulmonary artery stenosis, and hypercalcemia.
March 21, 2013
The “sutureless” neoatrium technique was initially described for anastomotic stenosis occurring after repair of total anomalous pulmonary venous connection (post-repair pulmonary vein stenosis, PRPVS). The procedure is also helpful in patients with congenital pulmonary vein stenosis and has been used in selected patients on the initial presentation of total anomalous pulmonary venous connection.
March 21, 2013
The surgical management of patients with tetralogy of Fallot and significant right ventricular outflow tract obstruction (RVOTO) remains controversial. The authors describe the use of a monocusp in patients with right ventricular outflow tract obstruction.
March 6, 2013
Editors Note
Patient Selection
November 12, 2012
Patient Selection
Patient Selection, Rationale for Use and Types of Valves
All patients with aortic valve disease who are candidates for aortic valve replacement with stented tissue valves.