Yuzuru Nakamura

Lobar emphysema due to ductus arteriosus compressing right upper bronchus in an infant with congenital heart disease

A 1-month-old boy with tetralogy of Fallot, pulmonary atresia, right aortic arch, and right ductus arteriosus, exhibited progressive right upper lobar emphysema since his birth. The emphysema was caused by the right ductus arteriosus compressing the right upper bronchus. After division of the ductus arteriosus the emphysema completely regressed. We should explore the cause of lobar emphysema thoroughly before lobectomy especially when it is extrinsic. The emphysema may regress by eliminating the extrinsic factor.

Aberrant right subclavian artery with preductal coarctation of the aorta

A 9-day-old boy diagnosed with an aberrant right subclavian artery, a preductal coarctation, and a ventricular septal defect underwent a subclavian flap coarctectomy. Subsequently, he underwent surgical closure of the ventricular septal defect at the age of 11 months. This case is extremely rare with regard to having an aberrant right subclavian artery originating from the proximal site of a preductal coarctation of the aorta.

A 4-year-old girl with giant left atrial diverticulum resulting in severe mitral regurgitation.

Left atrial diverticulum is rare in a pediatric patient. A 4-year-old girl underwent a left atrial plication concomitant with mitral valve replacement, and early postoperative course was uneventful. This patient has remained asymptomatic with no evidence of recurrent diverticular formation after 9 months of follow-up.

Pulmonary atresia with intact ventricular septum, antegrade coronary-right ventricular sinusoidal communication, and Wolff-Parkinson-White syndrome

A fenestrated Fontan operation was performed successfully in a patient with pulmonary atresia with intact ventricular septum, an antegrade sinusoidal communication, and Wolff-Parkinson-White syndrome. Unlike most cases, blood flow in the sinusoidal communication was antegrade, from the left anterior descending artery to the right ventricle. This is the first report of the combination of pulmonary atresia with intact ventricular septum and Wolff-Parkinson-White syndrome.

Extracardiac Direct Total Cavopulmonary Connection

We report a successful extracardiac direct total cavopulmonary connection without prosthetic materials performed in a 3-year-old boy with tricuspid atresia, infundibular pulmonary stenosis, and normally positioned great arteries. The transected pulmonary trunk was bought down posterolaterally with respect to the right atrium and was anastomosed end-to-end with the inferior vena cava.

Congenital thoracoabdominal aortic aneurysm

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Prosthetic Valve Replacement in Corrected Transposition with Severe Tricuspid Valve Dysfunction

修正大血管転位症(C-TGA)のおもな合併症である体側房室弁逆流(TR)は,房室ブロックと同様その予後に大きな影響を及ぼすが,小児期発症例における治療方針での異論は多い.今回,目立った合併心奇形のないC-TGA(S.L.L.)の2症例に対し,小児期に高度TRを認めたため人工弁置換術を施行した.臨床経過上の比較検討も併せて報告する.