CREATION OF A ONE-WAY INTERATRIAL COMMUNICATION IN THE TREATMENT OF CRITICAL PULMONARY STENOSIS WITH INTACT VENTRICULAR SEPTUM - A CASE-REPORT

Background: In biventricular repair of pulmonary outflow tract obstruc tion with intact ventricular septum, the right ventricle is loaded wit h total pulmonary blood flow acutely as the right-to-left shunt is abo lished by closure of the atrial septal defect (ASD), Methods: We desig ned a one-way interatrial communication by creation of an atrial septa l flap to reduce the excessive volume toad of the right ventricle, Res ults: This procedure was successfully performed in a 3-year-old girl u ndergoing definitive biventricular repair for critical pulmonary steno sis associated with tricuspid stenosis and a small right ventricle, Co nclusions: We believe that creation of a one-way interatrial communica tion might be a good alternative to adjustable ASD and/or bidirectiona l Glenn shunt in biventricular repair of critical pulmonary stenosis o r pulmonary atresia with intact ventricular septum.