[HSF] 20 year old year S/P DORV repair, Kawashima type spiral tunnel with...

[ICHFNO at aol.com]

The original op was for a doubly committed VSD. At reoperation she had  
multilevel obstruction, directly under the Ao valve as in a SAS, and then about  1 
cm down a fold of dacron the resulted in a 50% obstruction and then the VSD  
itself. We did this via Aorta and RV, completely removed the patch, enlarged 
the  VSD, resected SAS fibrous ridge and placed a bigger piece of Goretex. This 
of  course swellled into the RVOTO, so we added a Goretex RVOT patch. Residual 
 gradient was less than 16, and no RVOTO obstruction, and for Hal, she was  
extubated 4 hours later, and transferred to the floor the afternoon of PO1. 
 
Prasanna, I am in Shanghai, that is where the patients are coming from. I  
thought that it might be interesting to send some of our more complex cases for  
the groups review, will do so week after next from Minsk. 
 
Bill



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