This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kagami Miyaji Takashi Miyamoto Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tomoyasu, T. Articles by Inoue, N. Search for Related Content PubMed PubMed Citation Articles by Tomoyasu, T. Articles by Inoue, N.

The bilateral pulmonary artery banding for hypoplastic left heart syndrome with a diminutive ascending aorta

Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan

*Corresponding author. Department of Thoracic and Cardiovascular Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan.

E-mail address: kagami111{at}aol.com (K. Miyaji).

A one-day-old neonate who was diagnosed with hypoplastic left heart syndrome (HLHS), aortic atresia, with a diminutive ascending aorta, and mitral atresia, was referred to us for cardiogenic shock because of excessive pulmonary blood flow. The patient underwent bilateral pulmonary artery banding (bPAB). After bPAB, the patient's hemodynamics were still unstable because of coronary malperfusion, to proceed to undergo Norwood procedure at the age of 3 days. In this case, the stenosis of the ascending aorta, just proximal to the innominate artery caused coronary ischemia. The precise evaluation of the ascending aorta is necessary to perform the bPAB for HLHS with diminutive ascending aorta. If there is a sign of stenosis of the ascending aorta, the Norwood procedure should be performed as the first stage palliation, even for high-risk HLHS patients.

Key Words: Aortic arch; Hypoplastic left heart syndrome; Norwood; Ischemia; Pulmonary arteries