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We present a modified elephant trunk technique with a novel indication for aortic arch aneurysm with ragged, undilated descending thoracic aorta. Our modification is simple and effective for minimizing bleeding from the distal anastomosis and has the possibility of preventing distal embolization of atheromatous plaque by ensuring sufficient contact area between the graft and the aortic wall.

We report a long-term survivor with Uhl's anomaly who underwent one and a half ventricle repair combined with a partial right ventriculectomy in infancy, followed by successful total cavopulmonary conversion with right ventricular exclusion 5 years later. The combination of total cavopulmonary connection and right ventricular exclusion could be the optimal surgical option for a critically ill infant with Uhl's anomaly.

Objectives: Leaflet folding plasty was introduced for avoiding systolic anterior motion and coronary artery injury after mitral valve repair. We report the application and early outcome of this technique for mitral valve regurgitation. Methods: From January 1997 to January 2004,16 patients with mitral valve regurgitation were operated on using leaflet folding plasty. The group comprised 9 men and 7 women, with a mean age of 61.6 years. There were 15 patients with degenerative and 1 with ischemic mitral valve disease. The causes of mitral regurgitation were posterior mitral leaflet prolapse in 11 patients and commissural prolapse in 5 patients. Results: Mitral valve reconstruction could be performed in all patients. There were no perioperative deaths. Postoperative mitral regurgitation fell to 0.13±0.52 compared with 3.6±0.51 preoperatively. Systolic anterior leaflet motion was not observed in any patients after the procedure. The mean follow-up period was 22 months. There were no late deaths and reoperation was not required during follow-up. Conclusions: Early outcome of leaflet folding plasty for mitral valve repair was satisfactory. This technique may have advantages to accomplish mitral valve repair safely in patients with mitral regurgitation due to posterior or commissural prolapse.

We describe a new technique of mitral valve repair based on two reconstructive techniques: (1) the folding leaflet method, and (2) the classic annular plication. This combination appears to be useful in cases with a large prolapsing posterior mitral leaflet with excessive leaflet height or in cases with commissural prolapse involving both the anterior and posterior leaflets.

Patients with a functional single ventricle, unrestricted pulmonary blood flow, and aortic arch obstruction require staged palliation aimed at the Fontan circulation. Obstruction of the bulboventricular foramen (BVF), the communication between the left ventricle and the rudimentary right ventricle, may complicate the clinical course of patients with double-inlet left ventricle (DILV). In this report we present a new reconstructive approach for such morphology, applying a modifi

Hypoplastic left heart syndrome (HLHS) often involves abnormalities in atrial septal morphology, including a restrictive atrial communication and anomalous attachment of a malaligned septum primum. Cor triatriatum is a rare congenital heart abnormality in which the left atrium (LA) is divided into 2 chambers by a diaphragm. Association of cor triatriatum with HLHS is rare, and cor triatriatum is difficult to diagnose preoperatively. We herein describe an unusual case of HLHS with cor triatriatum.