Biventricular Repair after Bilateral Pulmonary Artery Banding as a Rescue Procedure for a Neonate with Hypoplastic Left Heart Complex

• Main Authors: Jae Kwang Yun, Ji Hyun Bang, Young Hwee Kim, Hyun Woo Goo, Jeong-Jun Park
• Format: Article
• Language: English
• Published: Korean Society for Thoracic and Cardiovascular Surgery 2016-04-01
• Series: Korean Journal of Thoracic and Cardiovascular Surgery
• Subjects: Congenital heart disease; Hypoplastic Left Heart Syndrome; Pulmonary artery; Biventricular repair
• Online Access: http://www.kjtcvs.org/journal/download_pdf.php?doi=10.5090/kjtcs.2016.49.2.107

Hypoplastic left heart complex (HLHC) consists of less severe underdevelopment of the left ventricle without intrinsic left valvular stenosis, i.e., a subset of hypoplastic left heart syndrome (HLHS). HLHC patients may be able to undergo biventricular repair, while HLHS requires single ventricle palliation (or transplant). However, there is no consensus regarding the likelihood of favorable outcomes in neonates with HLHC selected to undergo this surgical approach. This case report describes a neonate with HLHC, co-arctation of the aorta (CoA), and patent ductus arteriosus (PDA) who was initially palliated using bilateral pulmonary artery banding due to unstable ductus-dependent circulation. A postoperative echocardiogram showed newly appearing CoA and progressively narrowing PDA, which resulted in the need for biventricular repair 21 days following the palliation surgery. The patient was discharged on postoperative day 13 without complications and is doing clinically well seven months after surgery.