A word of caution regarding patients with hypoplastic left heart syndrome and a diminutive aorta

摘要

We report the case of a patient with a diminutive aorta who had an obstruction at the site of the aortic anastomosis with the pulmonary trunk at second-stage palliation. Caution in the case of a small aorta seems warranted, because on regular preoperative assessment before second-stage palliation, no irregularity in coronary blood supply was detected. Only a detailed echocardiographic assessment revealed the potentially life-threatening aortic stenosis.CLINICAL SUMMARY:A 4-month-old patient with hypoplastic left heart syndrome and aortic atresia was admitted electively for second-stage palliation. Previously, at a body weight of 3 kg, the patient had undergone neoaortic reconstruction, incorporating the ascending aorta by side-to-side anastomosis. At the heel of this side-by-side anastomosis, absorbable sutures were used. The augmentation of the neoaorta was completed with a homograft patch