Transarterial approach of the pulmonary artery in anatomically corrected malposition of the great arteries by manipulating a catheter inverted with balloon floating maneuver

We describe two neonates with anatomically corrected malposition of the gre at arteries (ACM). A 1-day-old female newborn, who had the salient clinical findings of Goldenhar syndrome, behaved like a patient with the tetralogy of Fallot. The cardiac malformations included ACM, perimembranous inlet and outlet ventricular septal defect with tricuspid valve straddling, conovent ricular septal malaligement, bilateral cori without aortic-mitral continuit y, pulmonary stenosis at subvalvular, valvular, and supravalvular levels, a nd bicuspid semilunar valves. After the procedure of left Blalock-Taussig s hunt at 3 months of age, cyanosis was alleviated. The other 1-month-old mal e newborn, who presented with prolonged feeding, tachypnea and tachycardia, likened to a patient with the hypoplastic left heart syndrome. He had a co mbination of ACM, mitral stenosis, hypoplastic left atrium and left ventric le, a restrictive patent foramen ovale, ventricular septal defect, subaorti c conus without aortic-mitral continuity, subaortic stenosis, and a narrow ascending aortic root. Rashkind balloon atrioseptostomy was done with limit ed success. He survived a Norwood procedure. Transarterial entry of the cat heter, which was inverted with the aid of balloon floating maneuver, to hoo k the retro-aortic pulmonary artery in ACM is recommended. (C) 1998 Elsevie r Science Ireland,Ltd. All rights reserved.