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NAOSITE : Nagasaki University's Academic Output SITE > School of Medicine > Bulletin > Acta Medica Nagasakiensia > Volume 35, No. 1-4 >

Temporary Division of the Superior Vena Cava For Extended Left Atriotomy ; Left-sided Atrioventricular Valve Repair in Corrected Transposition of the Great Arteries


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Title: Temporary Division of the Superior Vena Cava For Extended Left Atriotomy ; Left-sided Atrioventricular Valve Repair in Corrected Transposition of the Great Arteries
Authors: Hadama, Tetsuo / Shirabe, Joji / Takasaki, Hidemi / Mori, Yoshiaki / Oka, Keiji / Shigemitsu, Osamu / Kimura, Tatsunori / Miyamoto, Shinji / Uchida, Yuzo
Issue Date: 14-Dec-1990
Citation: Acta medica Nagasakiensia. 1990, 35(1-4), p.67-70
Abstract: The extended left atriotomy which combines the standard approach with the superior approach by concomitant temporary division of the superior vena cava (SVC) is a safe and useful method in the case of a small atrium. The approach used here is a modification of that which was reported by Selle and Kyger. This technique made it possible to sufficiently expose the laterally situated small left atrium in the case of corrected transposition of the great arteries (cTGA) which requires repair of the left-sided atrioventricular valve (tricuspid valve). In recent mitral surgery, median sternotomy is used with cannulation of the ascending aorta and both venae cavae to establish cardiopulmonary bypass. Although there are some approaches for left atriotomy, the standard procedure is to use vertical left atriotomy immediately posterior and parallel to interatrial sulcus. And in the case of combined mitral with tricuspid valve surgery, a right atriotomy with incision of interatrial septum has been employed to allow excellent exposure of the left atrium and mitral and tricuspid valve including subvalvular supporting structures. Surgical exposure of the mitral valve is often difficult by the conventional approach, especially in the patient with a small left atrium and a deep chest. In the case of cTGA too, sufficient exposure of the left atrium can not be obtained under median sternotomy on accout of anatomical abnormality. We performed prosthetic valve implantaion to the left-sided atrioventricular valve which is tricuspid valve in structure in the case of cTGA by means of new approach with the incision of the lateral to superior wall of the left atrium combined with division of the SVC temporarily. This technique was introduced by Selle 1) in a recent article.
URI: http://hdl.handle.net/10069/15814
ISSN: 00016055
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 35, No. 1-4

Citable URI : http://hdl.handle.net/10069/15814

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