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Haranal M, Srimurugan B, Dinh DM, Sivalingam S. Berry syndrome-a rare congenital cardiac anomaly. Indian J Thorac Cardiovasc Surg 2021; 37:526-532. [PMID: 34511759 DOI: 10.1007/s12055-021-01206-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 11/27/2022] Open
Abstract
Berry syndrome is a rare congenital cardiac anomaly, characterized by distal aortopulmonary window, hypoplasia or interruption of the aortic arch, intact ventricular septum, and aortic origin of the right pulmonary artery and patent ductus arteriosus. Anatomic depiction of each component is important for the diagnosis. Single-stage surgical repair is challenging but feasible with good survival outcomes. The available literature on this anomaly is limited. Hence, this paper aims at reviewing the literature on Berry syndrome.
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Affiliation(s)
- Maruti Haranal
- Department of Cardiac Surgery, National Heart Institute, 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
| | - Balaji Srimurugan
- Department of Pediatric Cardiac Surgery, Amrita Institute of Medical Sciences, Kerala Kochi, India
| | - Duyen Mai Dinh
- Department of Cardiac Surgery, National Heart Institute, 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
| | - Sivakumar Sivalingam
- Department of Cardiac Surgery, National Heart Institute, 145, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia
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Naimo PS, Fricke TA, Lee MGY, d'Udekem Y, Weintraub RG, Brizard CP, Konstantinov IE. Long-term outcomes following repair of truncus arteriosus and interrupted aortic arch. Eur J Cardiothorac Surg 2021; 57:366-372. [PMID: 31209463 DOI: 10.1093/ejcts/ezz176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/06/2019] [Accepted: 05/09/2019] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES We aim to evaluate the long-term outcomes following repair of truncus arteriosus with an interrupted aortic arch. METHODS We reviewed all children (n = 24) who underwent repair of truncus arteriosus and an interrupted aortic arch between 1979 and 2018 in a single institution. The morphology of the interrupted aortic arch was type A in 5, type B in 18 and type C in 1. RESULTS The median age at repair was 10 days and the median weight was 3.1 kg. Direct end-to-side anastomosis of the ascending and descending aorta was performed in 16 patients (67%, 16/24), patch augmentation in 5 patients (21%, 5/24) and direct anastomosis with the use of an interposition graft to the descending aorta in 2 patients (8%, 2/24). One patient, the first in the series, underwent interrupted aortic arch repair via subclavian flap aortoplasty prior to truncus repair. A period of deep hypothermic circulatory arrest was used in 16 patients, and isolated cerebral perfusion was used in 8 patients. The early mortality rate was 17% (4 out of 24 patients). There were no late deaths and overall survival was 83 ± 8% [95% confidence interval (CI) 61-93] at 20 years. Freedom from any reoperation was 33 ± 11% (95% CI 14-54) at 5 years and 13 ± 9% (95% CI 2-34) at 10 years. Six patients underwent 10 aortic reoperations. Freedom from aortic arch reoperation was 69 ± 11% (95% CI 42-85) at 10 and 20 years. Follow-up was 95% complete (19/20), with a median follow-up time of 20 years. At last follow-up, no clinically significant aortic arch obstruction was identified in any patient, and all patients were in New York Heart Association Class I/II. CONCLUSIONS Repair of truncus arteriosus with an interrupted aortic arch with direct end-to-side anastomosis results in good survival beyond hospital discharge. Although the long-term functional state of patients is good, reoperation rates are high.
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Affiliation(s)
- Phillip S Naimo
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Tyson A Fricke
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Melissa G Y Lee
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Yves d'Udekem
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Robert G Weintraub
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Christian P Brizard
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Igor E Konstantinov
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
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Habibie YA, Busro PW, Roebiono PS, Fakhri D. Berry syndrome; a successful one-stage repair in neonate periods, evaluation result after 9 years, a case report. Ann Med Surg (Lond) 2021; 64:102200. [PMID: 33732452 PMCID: PMC7941068 DOI: 10.1016/j.amsu.2021.102200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/28/2021] [Indexed: 11/17/2022] Open
Abstract
Backgroud IAA with an intact ventricular septum is distinctly unusual. Combination with an Aortopulmonary Window (APW), ascending aortic origin of the right pulmonary artery and PDA may be present which is called as Berry syndrome, a rare combination of cardiac anomalies, reported to be 0.046%, lethal combination and die shortly after birth. Case Report We report a 9 days-old male neonates weighing 3.85 kg was referred by local hospital to our center and was ventilated with history of respiratory distress and severe infection since he was born. Admitted to our PCICU, 2D echo showed an IAA type A associated with a huge APW type II and restrictif PDA. A PGE1 infusion was started, during the following days the baby experienced several epileptic episodes. After improvement of the clinical condition, surgery was performed on the 20th days of life on year 2011. A successful one-stage repair of such anomalies in which cutting of PDA that arised from PA trunk and distally becoming into descending aorta, extended end to end anastomosis to conduct the ascending aortic blood flow into the descending aorta and intra arterial baffle was used. A 4-0 Gore-Tex baffle was used both to close the APW and separated the RPA from aortic origin with a good result, as his recently grown up as a cheerful 9 year old child who is growing actively and has entered elementary school in grade 2. Conclusion Berry syndrome is a rare but well‐identified and surgically correctable anomaly. Early diagnosis and surgical treatment to avoid irreversible pulmonary hypertension is mandatory. Berry syndrome, a rare combination of cardiac anomalies, reported to be 0.046%, lethal combination and die shortly after birth. But well‐identified and surgically correctable anomaly. Early diagnosis and surgical treatment to avoid irreversible pulmonary hypertension is mandatory. Successful one-stage repair was done in a 20-days-old neonate using an alternative technique without circulatory arrest (performed on year 2011). Currently on year 2021, (after 9 years of evaluation) the patient has grown up as a cheerful 9 year old child who is growing actively and has entered elementary school in grade 2. During this patient last follow up on March 2019 at NCHHK Pediatric Cardiology clinic, echo result showed no residual AP Window, minimal pressure gradient of 18 mmHg across the aortic reconstruction with good LV function of 70%, good RV function, intact inter atrial & ventricular septum with TVG 20 mmHg. The latest echo follow up with the pediatric cardiologist showed good LV function with EF of 70%, no residual pumnonary hypertension was detected.
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Affiliation(s)
- Yopie Afriandi Habibie
- Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Syiah Kuala, The Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
| | - Pribadi Wiranda Busro
- Division of Pediatric and Congenital Cardiac Surgery, Dept of Thoracic and Cardiovascular Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Poppy S Roebiono
- Division of Pediatric Cardiology, Dept. of Cardiology and Vascular Medicine, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Dicky Fakhri
- Division of Pediatric and Congenital Cardiac Surgery, Dept of Thoracic and Cardiovascular Surgery, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
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Serrano Martínez F, Vázquez Sánchez A, Castelló Ginestar A, Cano Sánchez A, Martínez León J. Ventana aorto-pulmonar compleja. A propósito de 3 casos. CIRUGIA CARDIOVASCULAR 2021. [DOI: 10.1016/j.circv.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Naimo PS, Konstantinov IE. Surgery for Truncus Arteriosus: Contemporary Practice. Ann Thorac Surg 2020; 111:1442-1450. [PMID: 32828754 DOI: 10.1016/j.athoracsur.2020.06.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/24/2020] [Accepted: 06/03/2020] [Indexed: 11/12/2022]
Abstract
Surgery for truncus arteriosus has an early mortality of 3% to 20%, with a long-term survival of approximately 75% at 20 years. Nowadays, truncus arteriosus repair is mostly done in the neonatal period together with a single-staged repair of concomitant cardiovascular anomalies. There are many challenging subgroups of patients with truncus arteriosus, including those with clinically significant truncal valve insufficiency, an interrupted aortic arch, or a coronary artery anomaly. In fact, truncal valve competency appears to be the most important factor influencing the outcomes after truncus arteriosus repair. The use of a conduit during truncus arteriosus repair invariably requires reoperation on the right ventricular outflow tract. Through improvements in perioperative techniques over time, many children are now living well into adulthood after repair of truncus arteriosus, albeit with a high rate of reoperation. Despite this, the long-term outcomes of truncus arteriosus repair are good, with many patients being asymptomatic and with a quality of life comparable to the general population.
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Affiliation(s)
- Phillip S Naimo
- Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Igor E Konstantinov
- Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Melbourne Center for Cardiovascular Genomics and Regenerative Medicine, Melbourne, Victoria, Australia.
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Andrianova EI, Naimo PS, Fricke TA, Robertson T, Bullock A, Brink J, d'Udekem Y, Brizard CP, Konstantinov IE. Outcomes of Interrupted Aortic Arch Repair in Children With Biventricular Circulation. Ann Thorac Surg 2020; 111:2050-2058. [PMID: 32721457 DOI: 10.1016/j.athoracsur.2020.05.146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/13/2020] [Accepted: 05/18/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND To evaluate the outcomes after surgical repair of interrupted aortic arch in patients with biventricular circulation. METHODS We reviewed all children from a single institution (N = 177) who had interrupted aortic arch repair between 1978 and 2018. Patients were separated into simple (n = 122) and complex (n = 55) group based on their concomitant anomalies. RESULTS Median age at repair was 6 days (range, 1-298 days) and median weight was 3.1 kg (range, 0.95-5.1 kg). Median follow-up time was 11.5 years (mean 12.6 years; range, 0.1-35.9 years). Overall early mortality was 11.9% (21 of 177) and there were 5 late deaths. Era of surgery did not impact on overall survival (P = .37). Between 2000 and 2018, there was a significant difference in early mortality between the simple and complex group (3.2% [2 of 62] vs 24.1% [7 of 29], P = .002). There was an improvement in mortality in the simple group over time (P = .03). Competing risks analysis showed at 15 years after the initial operation 14% had died without arch reoperation, 15.2% had undergone aortic arch reoperation, and 70.8% were alive without arch reoperation. Reoperation on the aortic arch was more common in the complex group compared to the simple group (20.0% [11 of 55] vs 9.0% [11 of 122], P< .001). CONCLUSIONS Survival of patients with interrupted aortic arch and associated simple anomalies has improved over time, although mortality in patients with complex congenital cardiac lesions remains high.
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Affiliation(s)
- Eleonora I Andrianova
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Australia
| | - Phillip S Naimo
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Tyson A Fricke
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Terry Robertson
- Department of Cardiology, Women's and Children's Hospital, Adelaide, Australia
| | - Andrew Bullock
- Department of Cardiology, Perth Children's Hospital, Perth, Australia
| | - Johann Brink
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Yves d'Udekem
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Christian P Brizard
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia
| | - Igor E Konstantinov
- Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia.
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Hu R, Zhang W, Liu X, Dong W, Zhu H, Zhang H. Current outcomes of one-stage surgical correction for Berry syndrome. J Thorac Cardiovasc Surg 2016; 153:1139-1147. [PMID: 28089641 DOI: 10.1016/j.jtcvs.2016.11.058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 11/09/2016] [Accepted: 11/19/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Berry syndrome is a combination of distal aortopulmonary window (APW), aortic origin of the right pulmonary artery (RPA), intact ventricular septum, and interrupted aortic arch. We present here our current experience of primary repair of this syndrome with the goal of optimizing treatment for this rare condition. METHODS From January 2003 through December 2015, 16 infants with Berry syndrome underwent one-stage repair at Shanghai Children's Medical Center. Three different surgical correction techniques were used to repair the APW and aortic origin of the RPA, including intra-aortic baffle in 5, RPA detachment in 6, and RPA angioplasty with aortic cuff in 5 patients. RESULTS The median age at repair was 90.5 days (range, 8-170 days). The interrupted aortic arch morphology was type A in 14 and type B in 2 patients. The APW morphology was type IIa in 4, type IIb in 10, and type III in 2 patients. Hospital death occurred in 2 patients, and death at follow-up occurred in one other patient. Three patients who previously underwent RPA angioplasty with aortic cuff required reoperation for aortic or RPA stenosis. Freedom from reoperation was 84.8%, 75.4%, and 75.4%, respectively at 1, 5, and 10 years after surgery. CONCLUSIONS One-stage repair of Berry syndrome has achieved acceptable outcomes. Reoperations mainly are related to aortic or RPA stenosis, and the reoperation rate is higher when RPA arterioplasty is performed with an aortic cuff.
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Affiliation(s)
- Renjie Hu
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen Zhang
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xinrong Liu
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Dong
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hongbin Zhu
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haibo Zhang
- Department of Pediatric Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Naimo PS, Fricke TA, Yong MS, d'Udekem Y, Kelly A, Radford DJ, Bullock A, Weintraub RG, Brizard CP, Konstantinov IE. Outcomes of Truncus Arteriosus Repair in Children: 35 Years of Experience From a Single Institution. Semin Thorac Cardiovasc Surg 2016; 28:500-511. [DOI: 10.1053/j.semtcvs.2015.08.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 11/11/2022]
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Bobos D, Kanakis MA, Koulouri S, Giannopoulos NM. One-Stage Repair of an Interrupted Aortic Arch with an Aortopulmonary Window in a Premature Neonate. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2015; 48:411-4. [PMID: 26665109 PMCID: PMC4672977 DOI: 10.5090/kjtcs.2015.48.6.411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 08/28/2015] [Accepted: 09/08/2015] [Indexed: 11/16/2022]
Abstract
Interrupted aortic arch with an aortopulmonary window is a rare congenital entity that is associated with high morbidity and mortality, especially in premature low-birth-weight infants, and the proper timing of surgical correction remains a matter of debate. We present the case of a premature infant weighing 1.6 kg who successfully underwent one stage surgical repair to treat interrupted aortic arch with an aortopulmonary window. The therapeutic management of this patient is described below, and a review of the literature is presented.
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Affiliation(s)
- Dimitrios Bobos
- Department of Paediatric and Congenital Cardiac Surgery, Onassis Cardiac Surgery Centre
| | - Meletios A Kanakis
- Department of Paediatric and Congenital Cardiac Surgery, Onassis Cardiac Surgery Centre
| | - Sofia Koulouri
- Department of Paediatric and Congenital Cardiac Surgery, Onassis Cardiac Surgery Centre
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Singh J, Loona M, Suryavanshi A, Sahoo M, Mahant TS. Aortopulmonary Window With Anomalous Coronary Arteries. J Card Surg 2015; 30:846-8. [DOI: 10.1111/jocs.12636] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jiten Singh
- Department of Cardiothoracic and Vascular Surgery; Fortis Hospital; Mohali India
| | - Manpal Loona
- Department of Cardiothoracic and Vascular Surgery; Fortis Hospital; Mohali India
| | - Alok Suryavanshi
- Department of Cardiothoracic and Vascular Surgery; Fortis Hospital; Mohali India
| | - Manoranjan Sahoo
- Department of Cardiothoracic and Vascular Surgery; Fortis Hospital; Mohali India
| | - Tek S. Mahant
- Department of Cardiothoracic and Vascular Surgery; Fortis Hospital; Mohali India
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Aortopulmonary Window and the Interrupted Aortic Arch: Midterm Results With Use of the Single-Patch Technique. Ann Thorac Surg 2015; 99:186-91. [DOI: 10.1016/j.athoracsur.2014.08.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 07/24/2014] [Accepted: 08/07/2014] [Indexed: 11/23/2022]
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Naimo PS, Yong MS, d’Udekem Y, Brizard CP, Kelly A, Weintraub R, Konstantinov IE. Outcomes of Aortopulmonary Window Repair in Children: 33 Years of Experience. Ann Thorac Surg 2014; 98:1674-9. [DOI: 10.1016/j.athoracsur.2014.06.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 06/02/2014] [Accepted: 06/09/2014] [Indexed: 10/24/2022]
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Lin MC, Wang CC, Fu YC. Hybrid therapy for interrupted aortic arch with aortopulmonary window in a low birth weight infant. Catheter Cardiovasc Interv 2011; 78:945-7. [DOI: 10.1002/ccd.23160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Surgical Repair of Truncus Arteriosus Associated With Interrupted Aortic Arch: Long-Term Outcomes. Ann Thorac Surg 2011; 91:1473-7. [DOI: 10.1016/j.athoracsur.2010.12.046] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 12/21/2010] [Accepted: 12/23/2010] [Indexed: 11/19/2022]
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