A Left Anterior Extrapleural Approach to Adjust Right Ventricle-Pulmonary Artery Shunt Flow Using Hemostatic Clips After the Norwood Operation

Abstract

Adjusting right ventricle-pulmonary artery shunt flow with placement of hemostatic clips in the Norwood operation is a useful technique for precise control of pulmonary blood flow in the acute postoperative period. This report describes our technique for optimizing right ventricle-pulmonary artery shunt flow with metal clips through a left anterior extrapleural approach, which can be performed safely and minimally invasively without sternal reopening. This procedure may decrease morbidity and contribute to long-term clinical improvement in patients undergoing the Norwood operation.

Left Atrial Decompression by Minithoracotomy During Extracorporeal Life Support

“…We developed this LA decompression technique on the basis of our historical experience of pulmonary artery banding through the left anterior extrapleural approach, as reported by Yao and Mustard [7,8]. During the procedure, the left atrium had been identified close to the skin incision.…”