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Arterial Switch
Balloon Atrial Septostomy
Balloon Valvuloplasty
Blalock-Taussig shunt Through an opening on one side of the chest, the surgeon has to first identify and free the pulmonary artery and the subclavian branch of the aorta. He or she then applies clamps on both vessels, to prevent bleeding which may obscure vision during the creation of the shunt. The subclavian artery is divided, turned down and then stitched to an opening in the side of the pulmonary artery using fine hair-like thread made of Prolene. Although widely performed before, this shunt has a few problems. The isolation and division of the subclavian artery is a time consuming and difficult procedure. Also, it carries a small risk of damaging nerves that supply the hand and arm muscles, and blood supply to the upper limb. In the modified version, which is most commonly performed now, the subclavian artery is not divided. Instead, an artificial tube made of material like PTFE (a special polymer of ethylene) is used to make the connection. After applying clamps as usual, an opening is made in the side of the subclavian artery to which one end of the PTFE tube is stitched using fine thread. The other end of the PTFE tube is then brought down. It is stitched to another small opening in the side of the pulmonary artery. In this way, the same effect is achieved, without interrupting either artery and with lesser risk. The effects of a Blalock-Taussig shunt are immediate, and usually last long. The severity of cyanosis ("blueness") is reduced. However, it is only a temporary measure. It aims to improve oxygen supply and promote growth of the pulmonary artery branches. Once these aims are achieved, a total correction operation can be performed safely. How safe is a Blalock-Taussig shunt operation ? A Blalock-Taussig shunt is a reasonably safe procedure, with a risk of death below 1%. Complications are rare and include: 1. Blockage of the shunt. This makes the blue color return, and may need medicines to dissolve the clot, or sometimes even a repeat operation to remove clot or create another shunt. 2. Infection. Since the PTFE tube is a "foreign" material, it may become the site of growth for germs that cause infection. 3. Excessive lung blood flow. This happens rarely when the size of PTFE tube used is too big for the child's size. If allowed to continue for a long time, this may cause thickening and hardening of the lung blood vessels. This may make future total correction impossible. 4. Distortion of the pulmonary artery. As a child grows, the point at which the PTFE graft is stitched to the artery may not grow at the same rate, causing a bend, or kink, at that region.
Damus-Kaye-Stansel procedure
DORV Repair
Fontan Procedure or Operation The aim of this operation is to separate the deoxygenated (blue) blood from the oxygenated (red) blood. It is done by:- a)Creating a baffle (wall) in the right atrium (right collecting chamber) to prevent the deoxygenated (blue) blood from returning to the heart. b)Attaching the right atrium (right collecting chamber) to the pulmonary artery. All the returning deoxygenated (blue) blood will now be flowing straight to the lungs. Since this will cause an increase in pressure in the lung vessels, a small fenestration (hole) will be created in the baffle (wall). This hole acts as a pressure relief valve whilst the child becomes used to its new circulation.
Glenn Procedure or Operation Although not exactly a Fontan operation, a bidirectional Glenn shunt is similar to it and is called a type of "Partial Fontan"or "Hemi Fontan" operation. The bidirectional shunt is performed by connecting the superior vena cava (SVC) to the right branch of the pulmonary artery using fine sutures, and dividing or tying up the pulmonary artery. Now, venous blood from the head and upper limbs will pass directly to the lungs, bypassing the right ventricle. The venous blood from the lower body however will continue to enter the heart.
Heart Transplant
IAA Repair
Norwood Procedure or Operation This is a multi-stage procedure to treat HLHS. The first stage is usually performed within the first week of life. It is an "open-heart" operation, done using the heart-lung machine. The aorta, which is very small in HLHS, is entirely reconstructed by an ingenious technique. The initial portion of the pulmonary artery, the small aorta, and an AORTIC HOMOGRAFT are stitched together in such a way that an almost normal-sized new aorta - called a "NEO-AORTA" is built. This neo-aorta has a connection with the right ventricle through the pulmonary artery. So the right ventricle now acts as the chamber pumping blood to the whole body. At this time, the wall between the two upper chambers (atrium) - the interatrial septum - is also cut away. This is done so that there is no obstruction to blood returning from the lungs into the left atrium and flowing into the right ventricle. To provide blood flow into the lungs, a new channel is created by making a modified BLALOCK-TAUSSIG SHUNT using a 3.5 to 4 millimeter sized PTFE (Gore-tex) tube graft.
Pulmonary Artery Banding
Pulmonary Valvotomy
Ross Procedure
Shunt or Shunting Procedure
Stent Procedure
TOF Repair
Truncus Repair
Ventricle-and-a-Half Repairs
Venous Switch or Intra-atrial Baffle
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