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 obstruction with intact ventricular septum, the right ventricle is loaded with total pulmonary blood flow acutely as the right-to-left shunt is abolished by closure of the atrial septal defect (ASD).

METHODS

We designed a one-way interatrial communication by creation of an atrial septal flap to reduce the excessive volume load of the right ventricle.

RESULTS

This procedure was successfully performed in a 3-year-old girl undergoing definitive biventricular repair for critical pulmonary stenosis associated with tricuspid stenosis and a small right ventricle.

CONCLUSIONS

We believe that creation of a one-way interatrial communication might be a good alternative to adjustable ASD and/or bidirectional Glenn shunt in biventricular repair of critical pulmonary stenosis or pulmonary atresia with intact ventricular septum.