Aortic regurgitation in the pediatrics who had previous cardiac surgery is increased with their improved longterm survival rate and their complexity of heart disease. So the need of aortic valve surgery in pediatrics is also on the increase. A 10-year old boy was admitted for progressive cyanosis and dyspnea on exertion(DOE). The patient had been underwent lateral tunnel Fontan operation before. Echocardiography and cardiac catheterization study revealed hepatic vein drained to pulmonary atrium via intrahepatic collaterals, moderate atrioventricular regurgitation, and severe aortic regurgitation due to aortic root dilation. We report a case who had aortic root reconstruction, valvuloplasty of the atrioventricular valve, and hepatic vein ligation successfully. Cyanosis and DOE was dramatically improved after the operation
Aortic Valve ; Aortic Valve Insufficiency ; Cardiac Catheterization ; Cardiac Catheters ; Child ; Cyanosis ; Dyspnea ; Echocardiography ; Fontan Procedure* ; Heart Diseases ; Hepatic Veins ; Humans ; Ligation ; Male ; Pediatrics ; Survival Rate ; Thoracic Surgery

We report successful application of dual tracheobronchial stent to the diffuse tracheal stenosis. An one-month-old boy was transferred to the emergency room due to tachypnea and respiratory difficulty with CO2 retention. Preoperative computed tomography revealed pulmonary artery sling with diffuse tracheal stenosis. We found that the diameter of the both main bronchus was less than 3mm and the trachea was a complete ring. We divided the left pulmonary artery and implanted it to the main pulmonary artery under cardiopulmonary bypass. After that, tracheoplasty was performed with autologous pericardium. However, after the initial measures, CO2 retention and respiratory difficulty persisted due to the granulation tissue and dynamic obstruction of the airway ensued by the overlying pericardial flap. Therefore, we decided to apply a single tracheal stent. After the insertion of tracheal stent, residual stenosis of the both main bronchus opening continued to cause respiratory difficulty. Finally we applied dual tracheobronchial stent and resolved the airway obstruction.
Airway Obstruction ; Bronchi ; Cardiopulmonary Bypass ; Constriction, Pathologic* ; Emergency Service, Hospital ; Granulation Tissue ; Humans ; Male ; Pericardium ; Pulmonary Artery ; Stents* ; Tachypnea ; Trachea ; Tracheal Stenosis