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Background: Pregnancy outcomes after the arterial switch operation (ASO) are rare. We sought to determine outcomes of ASO survivors who underwent pregnancy.Methods: Female patients who had an ASO and underwent pregnancy were identified from the congenital heart disease pregnancy clinic at The Royal Melbourne Hospital. All follow-up data were collected retrospectively by medical record review.Results: Eleven (11) women were identified as having undergone medical care during pregnancy, from the adult congenital database, at The Royal Melbourne Hospital. There were 17 successful pregnancies, and nine women have been followed post pregnancy. Of the 17 successful deliveries, eight were delivered by Caesarean section, seven were vaginal deliveries and two were instrumented vaginal deliveries. Of the eight Caesarean sections, five were emergency and three were elective. The indications for emergency Caesarean section were obstructed labour (n = 2), abnormal cardiotocography (n = 1), obstructed labour and abnormal cardiotocography (n = 1) and congestive cardiac failure (n = 1). There was one neonatal complication (respiratory distress requiring intubation) in a child born at 31 weeks. There were maternal obstetric complications in 10 patients. There were two maternal cardiac complications during pregnancy (heart failure and rapid atrial fibrillation/flutter). There was no change in left ventricular function post-pregnancy. There was progression of severity of neo-aortic valve regurgitation in two patients post pregnancy (trivial to mild and moderate-severe to severe respectively).Conclusion: Pregnancy post ASO appears to be safe in the majority of women. Maternal cardiac complications are uncommon in patients without residual significant haemodynamic lesions, although maternal obstetric complications may be common. [ABSTRACT FROM AUTHOR]

Atrial septal defect (ASD) closure is usually performed in children via a conventional sternotomy. In striving to improve the cosmetic result, we have adopted a lower ministernotomy approach with a very small skin incision. We present a single surgeon experience of 110 consecutive patients undergoing surgical closure of ASD, comparing conventional (n=55) and mini-sternotomy (n=55) approaches. Our ministernotomy technique avoids direct superior vena cava cannulation, allowing for a smaller incision, while providing adequate exposure. The ministernotomy approach is safe and provides an excellent cosmetic result. [ABSTRACT FROM AUTHOR]

Peripheral veno-artertial extracorporeal membrane oxygenation (VA-ECMO) is commonly used in the paediatric population for intractable respiratory and cardiac failure. One of the devastating complications of VA-ECMO is severe brain damage due to ischemia or haemorrhage. We describe a case of peripheral cervical VA-ECMO complicated by evolving right cerebral ischemia which was rescued with rapid conversion from peripheral to central VA-ECMO support. Notably, the patient had a complete circle of Willis. Following conversion, we observed complete resolution of neurological symptoms with full functional recovery. [ABSTRACT FROM AUTHOR]

To deal with the lack of innominate vein, they retained the central pulmonary artery between the 2 bidirectional cavopulmonary shunt anastomoses as a type of "neo-innominate vein" and completed the transplant using a bi-atrial technique. Keywords: Heart transplantation; Univentricular circulation; Congenital heart disease EN Heart transplantation Univentricular circulation Congenital heart disease 1 1 1 12/05/22 20221201 NES 221201 Heart transplantation for the failed univentricular circulation is technically demanding. Transplantation for univentricular hearts - prepare to succeed!. [Extracted from the article]

In 1908, Alexander I. Ignatowski (1875-1955) published his pioneering work that first revealed a relationship between cholesterol-rich food and experimental atherosclerosis. This early experimental work paved a way to the metabolic study of the mechanism of atherosclerosis. Herein, we present a brief account of Ignatowski's work and life. [ABSTRACT FROM AUTHOR]

Objectives. To assess dynamic changes in myocardial oxygen consumption (myoVO2) during atrial pacing increased heart rate by continuous measurement of systemic oxygen consumption (sysVO2). Methods. Six mechanically ventilated pigs were atrially paced to increase heart rate from baseline 98 ± 9 to 120-140-160-180 bpm for 10 minutes at each stage, with 10 minute intervals without pacing between stages. sysVO2 was continuously measured with a respiratory mass spectrometer. Left anterior descending coronary arterial flow, aorta and coronary sinus blood gases were measured to calculate index of whole heart myoVO2. Results. sysVO2 peaked at the initiation of pacing in the first two to three minutes, followed by a decrease and subsequent stabilization. As heart rate increased, sysVO2 increased by 0.08 ± 0.06 ml/kg/min, 0.14 ± 0.05 ml/kg/min and 0.17 ± 0.10 ml/kg/min, representing a 1.2 ± 0.9%, 2.1 ± 0.7% and 3.0 ± 1.8% increase of sysVO2 respectively; myoVO2 increased by 0.16 ± 0.12 to 0.31 ± 0.14 to 0.36 ± 0.24 ml/100 g/min, representing a 11 ± 9%, 21 ± 9% and 26 ± 12% increase of myoVO2, respectively. The absolute and relative increases in sysVO2 were significantly correlated with the increases in myoVO2. Conclusions. On-line continuous sysVO2 monitoring by respiratory mass spectrometry allows non-invasive assessments of dynamic changes in myoVO2 in vivo. The mechanism for the peaked increase in sysVO2 at the initiation of pacing remains to be explored. [ABSTRACT FROM AUTHOR]

Taussig-Bing anomaly is a rare congenital heart malformation that was first described in 1949 by Helen B. Taussig (1898-1986) and Richard J. Bing (1909-). Although substantial improvement has since been achieved in surgical results of the repair of the anomaly, management of the Taussig-Bing anomaly remains challenging. A history of the original description of the anomaly, the life stories of the individuals who first described it, and the current outcomes of its surgical management are reviewed herein. [ABSTRACT FROM AUTHOR]

Vladimir P. Demikhov (1916-1998) performed the world's first experimental intrathoracic transplantations and coronary artery bypass operation. His successes heralded the era of modern heart and lung transplantation and the surgical treatment of coronary artery disease. Even though he was one of the greatest experimental surgeons of the 20th century, his international isolation fueled speculation, suppositions, and myths. Ironically, his transplantation of a dog's head drew more publicity than did his pioneering thoracic surgical accomplishments, and he became an easy target for criticism. An account of Demikhov's life and work is presented herein. [ABSTRACT FROM AUTHOR]

Patients who experience hemodynamic collapse after acute massive pulmonary embolism have a poor prognosis. Herein, we report our results with 8 patients and discuss a surgical strategy that can improve perioperative survival. From August 1994 through May 2005, 8 consecutive patients (6 women, 2 men; age range, 27-68 yr) were urgently referred to our unit after experiencing hemodynamic collapse. All required cardiopulmonary resuscitation. Seven patients underwent pulmonary embolectomy. One patient was successfully treated with thrombolytic therapy alone under continuous monitoring by the surgical team. There were 2 intraoperative deaths (30-day mortality rate, 28.5%). One survivor required a right ventricular assist device. Follow-up of the patients ranged from 8 months to 8 years. One patient died 8 months after the pulmonary embolectomy from long-term complications of cerebral damage that had occurred during preoperative resuscitation. We conclude that prompt surgical management improves the early survival rates of patients who require cardiopulmonary resuscitation patients who require cardiopulmonary resuscitation subsequent to massive pulmonary embolism. [ABSTRACT FROM AUTHOR]

Nikolai N. Anichkov (1885-1964) first demonstrated the role of cholesterol in the development of atherosclerosis. His classic experiments in 1913 paved the way to our current understanding of the role of cholesterol in cardiovascular disease. Anichkov's research is often cited among the greatest discoveries of the 20th century; however, little is known about Anichkov and his team. Herein, we give a detailed historical account of Anichkov's work, his personality, his research team, and their pioneering effort. [ABSTRACT FROM AUTHOR]

In the present review we discuss anatomical, physiological and technical aspects of the interventional transcatheter deployment of intracardiac covered stent for completion of the total cavopulmonary connection. [ABSTRACT FROM AUTHOR]

In the dawn of cardiac surgery in the 1940s to 1950s, Alexander A. Vishnevsky assembled together a fine team of surgeons and conducted intense surgical research that resulted in clinical application of modified Blalock-Taussig shunt, cavo-pulmonary shunt, and paved the way to clinical orthotopic heart and lung transplantation and coronary bypass surgery in Russia. The team of surgeons lead by Vishnevsky also performed the world's first cavo-pulmonary shunts and experimental orthotopic heart and lung transplantation. Herein, we describe the pioneering contributions of Vishnevsky and his team to cardiac surgery. [ABSTRACT FROM AUTHOR]

Profiles cardiovascular surgeon Vasilii I. Kolesov. Contribution to the development of the coronary artery bypass grafting operation; Use of coronary stapling in coronary surgery; Personal background; Work of Kolesov during the occupation of Leningrad, Russia by German troops.

Burckhard Friedrich Kommerell's scholarly description of the aortic diverticulum that bears his name was published in 1936. In the international literature, however, the name of Kommerell survives only as an eponym. We present biographical information about Kommerell, as supplied by family members, and comment on the surgical relevance of his 1936 report. (Tex Heart Inst J 2002;29:109-12) [ABSTRACT FROM AUTHOR]

Pays tribute to cardiac surgeon Yustin Djanelidze, who died on January 14, 1950. Personal and career background; Details on the surgical repair of the aorta he performed in 1913.

Profiles histologist Alexander A. Maximow. Development of a unitarian theory of hematopoiesis; Work in the Russian military; Skepticism towards his theory.

Two cases of carinal and tracheal reconstruction with the aid of cardiopulmonary bypass (CPB) are presented. The technical problems of surgery and anaesthesia which necessitated CPB in these two patients are discussed. CPB provides both adequate oxygenation and an unobstructed surgical field with optimal access to the trachea and carina. It permits atraumatic handling of the airways and reduction of anastomotic tension during the repair. [ABSTRACT FROM AUTHOR]

Aortic valve replacement is the standard surgical procedure for severe aortic regurgitation. Due to advances over the past decade, there have been substantial improvements in aortic root graft design, in aortic valve repair techniques, and in the understanding of valvular function in the remodeled aortic root. Herein, we describe the case of a dyspneic patient with an asymmetric bicuspid aortic valve who underwent valve-sparing aortic root replacement and tricuspidization. The patient subsequently resumed strenuous physical activity and was asymptomatic 2 years after the operation. [ABSTRACT FROM AUTHOR]

Iatrogenic oesophageal injury is a common cause of oesophageal perforation. This complication carries a poor prognosis in the setting of malignancy of oesophagus. We discuss the role of stents in the management of a case in this clinical scenario. [Copyright &y& Elsevier]

The article discusses the successful repair of interrupted aortic arch (IAA) with transposition of great arteries and hypoplastic right ventricle (RV) in a seven-day-old infant. It states that IAA is an uncommon disease, present in about 1.3% of patients with congenital heart disease. It notes that a single-stage palliative repair was performed via a midline sternotomy. It cites the use of a homograft patch in reconstructing the aortic arch.

A 36-year-old man with cystic fibrosis and severe portal hypertension underwent en bloc heart–double lung–liver transplantation. An early extubation with an aggressive physiotherapy made an early ambulation feasible and contributed to an early discharge from the hospital. [Copyright &y& Elsevier]

Herein we describe a patient with an unusually large bronchogenic cyst. The removal of the cyst was performed through a mini-thoracotomy and facilitated by video-assisted thoracic surgery (VATS). [Copyright &y& Elsevier]

Thymomas are common mediastinal tumours. We report a rare case of thymoma invasion into the superior vena cava with resultant venous obstruction. The tumour was resected. The superior vena cava and left brachiochephalic vein were reconstructed with autologous pericardial patch. [Copyright &y& Elsevier]

A letter to the editor about the case of a patient having iatrogenic oesophageal perforation associated with necrotizing mediastinitis is presented.

A patient with healed prosthetic endocarditis, severe calcification of the mitral annulus, and multiple mitral periprosthetic leaks underwent double-valve replacement, with reconstruction of the intervalvular fibrous body. Placing sutures through healthy autologous tissues from outside the heart enabled secure replacement of the mitral prosthesis. This technique avoids extensive circumferential reconstruction of the mitral annulus. [ABSTRACT FROM AUTHOR]

A patient with Marfan syndrome underwent valve-preserving aortic root reconstruction with a Robicsek-Thubrikar graft. Intraoperative transesophageal echocardiography showed aortic insufficiency after extracorporeal circulation was discontinued. Placing 3 subcommissural annuloplasty sutures corrected the severe aortic insufficiency. Herein, we discuss the mechanism and prevention of aortic regurgitation after aortic root replacement with a new graft that contains pre-designed aortic sinuses. (Tex Heart Inst J 2003;30:243-5) [ABSTRACT FROM AUTHOR]

Vancomycin-resistant Enterococcus faecium endocarditis is rare and usually occurs in immunocompromised patients. We describe a patient with hairy-cell leukemia and vancomycin-resistant E faecium endocarditis. The patient presented with severe aortic insufficiency. He underwent aortic root replacement with a cryopreserved aortic homograft and was treated with a combination of quinupristin/dalfopristin, ampicillin, and gentamicin. [ABSTRACT FROM AUTHOR]

Heart transplantation (HT) in patients with failing univentricular circulation is often challenging. This is compounded by the ever-increasing number of patients with prior Norwood-type reconstruction of the aorta, large aortic root, and often dense adhesions from multiple prior operations. We aimed to elucidate differences in outcomes of HT in patients with prior univentricular palliations, with and without prior Norwood-type aortic arch reconstruction (ArchRec). All patients who underwent HT for failed univentricular palliation during the 1990–2022 period were included in the study. Of 45 patients, 18 had undergone ArchRec. Hospital mortality improved in the recent era (17.4% before 2006 vs 0% after 2006; p=0.11), despite a higher proportion of patients with ArchRec (17.4% before 2006 vs 60.8% after 2006, p=0.002). Patients with ArchRec had a higher number of prior cardiac surgeries (4.1±1.5 vs 3.2±1.3, p=0.04), longer cardiopulmonary bypass time (320±23 vs 242±21 min, p=0.02), more concomitant arch reconstruction (33.3% vs 0%, p=0.02), greater need for post-HT extracorporeal membrane oxygenation (33.3% vs 3.7%; p=0.01) and longer hospital stay (37.1±30.5 days vs 23.6±11.8 days, p=0.04). Freedom from death or retransplantation for all patients was 91%, 73%, 67%, and 53% at 1, 5, 10, and 15-years, respectively. Prior ArchRec, Fontan procedure, and earlier eras were not risk factors for death. The outcomes of HT after univentricular palliation have improved in recent times and low operative mortality can be achieved. Despite increased complexity, good similar outcomes can be achieved in patients with and without prior arch reconstruction regardless of the palliation stage. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES The aim of this study was to assess the early outcomes and risk factors of paediatric patients requiring extracorporeal membrane oxygenation after cardiac surgery (post-cardiotomy). METHODS Retrospective binational cohort study from the Australia and New Zealand Congenital Outcomes Registry for Surgery database. All patients younger than 18 years of age who underwent a paediatric cardiac surgical procedure from 1 January 2013 to 31 December 2021 and required post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO) in the same hospital admission were included in the study. RESULTS Of the 12 290 patients included in the study, 376 patients required post-cardiotomy ECMO (3%). Amongst these patients, hospital mortality was 35.6% and two-thirds of patients experienced a major complication. Hypoplastic left heart syndrome was the most common diagnosis (17%). The Norwood procedure and modified Blalock–Taussig shunts had the highest incidence of requiring PC-ECMO (odds ratio of 10 and 6.8 respectively). Predictors of hospital mortality after PC-ECMO included single-ventricle physiology, intracranial haemorrhage and chylothorax. CONCLUSIONS In the current era, one-third of patients who required PC-ECMO after paediatric cardiac surgery in Australia and New Zealand did not survive to hospital discharge. The Norwood procedure and isolated modified Blalock–Taussig shunt had the highest incidence of requiring PC-ECMO. Patients undergoing the Norwood procedure had the highest mortality (48%). Two-thirds of patients on PC-ECMO developed a major complication. [ABSTRACT FROM AUTHOR]

Currently, the extracardiac Fontan operation is a procedure of choice in patients undergoing a staged palliation for univentricular hearts. However, it is not always easy to prevent the right pulmonary artery twisting after implantation of the extracardiac conduit. Herein, we described a simple modification, which we referred to as T-Fontan procedure, to prevent right pulmonary artery stenosis after extracardiac Fontan operation. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES The Bex-Nikaidoh operation can effectively relieve left ventricular outflow tract obstruction. However, if a conduit is used for right ventricular outflow tract reconstruction, a late reoperation can be anticipated. We examined the impact of double root translocation on outcomes. METHODS We performed a retrospective single-centre study of patients who underwent aortic root translocation between 2006 and 2019. RESULTS Aortic root translocation was performed in 23 patients at a median age of 1.6 years [interquartile range (IQR) 0.9–2.5]. Concomitant repairs were done in 52.2% of patients (12/23) including the Senning atrial switch in 34.8% (8/23). The right ventricular outflow tract was reconstructed with valved conduits in 39.1% (9/23), direct anastomoses in 4.35% (1/23) and pulmonary autografts in 56.5% of patients (13/23). Aortic cross-clamp time was significantly longer in patients with double root translocation [308 min (IQR 270–259) vs 209 min (IQR 179–281), P  =   0.02]; 2 patients in this group required temporary mechanical circulatory support. There were no early deaths. Median follow-up time was 7.5 years (IQR 3.3–10.5). The estimated 10-year survival was 90% [95% confidence interval (CI): 47.3%, 98.5%]. There was no recurrent left ventricular outflow tract obstruction. Freedom from any reoperation was 64.2% (95% CI: 40.8%, 80.3%) at 3 years and 44.5% (95% CI: 21.2%, 65.5%) at 6 years. The main indication for late reoperation was conduit degeneration. Freedom from a right ventricular outflow tract reoperation was significantly higher, and the number of reoperations per patient was lower when a double root translocation had been performed (P  =   0.03). CONCLUSIONS The Bex-Nikaidoh operation effectively relieved left ventricular outflow tract obstruction. A double root translocation further increased procedural complexity but was associated with better mid-term freedom from a right ventricular outflow tract reoperation. It should be considered in suitable patients. [ABSTRACT FROM AUTHOR]

Remote ischaemic preconditioning (RIPC) has been employed as a non‐invasive protective intervention against myocardial ischaemia–reperfusion injury in animal studies. However, the underlying mechanisms are incompletely defined in humans and its clinical efficacy has been inconclusive. As advanced age, disease, and drugs may confound RIPC mechanisms in patients, our aim is to measure whether RIPC evokes release of adenosine, bradykinin, met‐enkephalin, nitric oxide, and apolipoproteins in healthy young adults. Healthy subjects (n = 18, 9 males, 23 ± 1.5 years old; 9 females, 23 ± 1.8 years old) participated after informed consent. RIPC was applied using a blood pressure cuff to the dominant arms for four cycles of 5‐minute cuff inflation (ischaemia) and 5‐minute cuff deflation (reperfusion). Blood was sampled at baseline and immediately after the final cuff deflation (Post‐RIPC). Baseline and Post‐RIPC plasma levels of adenosine, bradykinin, met‐enkephalin, apolipoprotein A‐1 (ApoA‐1), apolipoprotein D (ApoD), and nitric oxide (as nitrite) were measured via ELISA and high‐performance liquid chromatography. Mean (±SD) baseline levels of adenosine, bradykinin, met‐enkephalin, ApoA‐1, ApoD, and nitrite in healthy young adults were 13.8 ± 6.5 ng/mL, 2.6 ± 1.9 μg/mL, 594.1 ± 197.4 pg/mL, 3.0 ± 0.7 mg/mL, 22.2 ± 4.0 μg/mL, and 49.8 ± 13.4 nmol/L, respectively. Post‐RIPC adenosine and nitrite levels increased (59.5 ± 37.9%, P < .0001; 32.2 ± 19.5%, P < .0001), whereas met‐enkephalin and ApoD levels marginally decreased (5.3 ± 14.0%, P = .04; 10.8 ± 20.5%, P = .04). Post‐RIPC levels were not influenced by sex, age, blood pressure, waist circumference, or BMI. RIPC produces increased levels of adenosine and nitrites, and decreased met‐enkephalin and ApoD in the plasma of young healthy adults. [ABSTRACT FROM AUTHOR]

Background: Sternal dehiscence following midline sternotomy is associated with significant morbidity and mortality in high-risk patients. Methods: A novel simple technique of sternal stabilization after midline sternotomy by interlocking wires was introduced in high-risk patients with morbid obesity, diabetes, osteoporosis, chronic obstructive pulmonary disease, bilateral internal thoracic artery harvesting, or various combinations of the above. Results: A sternal stabilization by interlocking wires was performed in 25 consecutive high-risk patients. Stable sternum was achieved in all patients despite multiple risk factors. Conclusion: We describe a simple technique of interlocking wires that provides excellent stabilization of the sternum after midline stenotomy in high-risk patients. This technique utilizes the benefit of figure-eight wires, provides the continuity of the weave and effectively prevents cutting of the wires through the sternum without compromising its blood supply. [ABSTRACT FROM AUTHOR]

The article focuses on diagnostic imaging and surgical management of spontaneous multivessel coronary dissection in a 51-year-old postmenopausal woman. A diagnosis of acute inferior myocardial infarction was made based on electrocardiographic (ECG) results. Urgent coronary angiography was performed due to severe angina recurrence, as extensive dissection involving the left anterior descending and left circumflex coronary arteries was seen. Insertion of an intra-aortic balloon pump was made and coronary artery bypass surgery was performed.

A large thrombus entrapped in an atrial septal defect is a rare condition that can lead to life-threatening systemic and pulmonary embolization. The use of thrombolysis may prove dangerous to the patient. Herein, we describe the emergency surgical management that contributed to a successful outcome in a 67-year-old man who was found to have a 23-cmlong thrombus across an atrial septal defect. [ABSTRACT FROM AUTHOR]

Subscapular abscess is a rare clinical problem. Herein we describe a young male patient who presented with a subscapular abscess and was managed successfully with surgical drainage and debridement of the cavity. [Copyright &y& Elsevier]

A letter to the editor is presented that affirms the safeness of the top-end saphenous vein markers to patients undergoing coronary artery surgery.

Mitral valve repair has become an established treatment in adults, but there is limited experience with the procedure in children, in whom the avoidance of a valve prosthesis is particularly advantageous. Repair of the mitral valve in children who have Marfan syndrome is especially difficult due to the presence of generalized connective tissue disorder, which may lead to future elongation and rupture of chordae tendineae that were unaffected at the time of mitral valve repair. We performed a total augmentation of all segments of the mitral valve, using artificial chordae tendineae. Herein, we describe the procedure and the positive outcome in a 10-year-old girl. [ABSTRACT FROM AUTHOR]

This article presents the case of acute massive pulmonary embolization with hemodynamic collapse. It discusses the clinical history of the patient, the findings of the physical and laboratory examinations performed on the patient, and the management of the disease. A discussion on intracardiac migration of an inferior vena cava filter is given.

A letter to the editor is presented which offers information on a simple technique for sternotomy closure in obese patients.

Tube thoracostomy is a very commonly performed procedure in cardiothoracic surgery. Insertion of a chest drain requires expertise to minimize complications. We describe a simple technique of using a nasal speculum to perform this procedure. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article on the use of a recirculator device for pericardial cold saline irrigation in cardiac surgery.

Patients with dextrocardia and d-transposition of the great arteries (d-TGA) present a technical challenge when performing the arterial switch operation (ASO). We sought to determine the long-term outcomes of this rare presentation. All patients who underwent the ASO with d-TGA and dextrocardia were identified from the hospital database. There were four patients with dextrocardia (4 of 844, 0.5%) patients; two patients had situs solitus and two patients had situs inversus. Three patients had a ventricular septal defect. Left ventricular outflow tract obstruction was present in one patient and one patient had a hypoplastic arch with severe coarctation of aorta. Anomalous coronary anatomy occurred in two patients. There was one early mortality and the cause of death was sepsis. One patient required late reoperation for severe neo-pulmonary valve regurgitation at 23 years after the ASO. At last follow-up, all three surviving patients were in New York Heart Association Class I. Patients with d-TGA and dextrocardia who undergo the ASO are extremely rare and require challenging operative management. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Pulmonary artery banding (PAB) remains in the armamentarium of techniques for several congenital cardiac anomalies, but necessitates a reoperation for eventual removal. We sought to assess the efficacy of an absorbable PAB in obviating the requirement for reoperation. METHODS: From 2003 to 2015, 45 consecutive patients with a median age of 1.6 months (2 days-11 months) underwent placement of a polydioxanone absorbable PAB. In 28 patients (62%), the band was placed concomitantly to a ventricular septal defect (VSD) closure and in 17 (38%), the band was the sole procedure for the VSDs. Fourteen patients had additional cardiac anomalies and 9 patients had aortic arch anomalies, which were repaired at the time of absorbable PAB placement. RESULTS: There was 1 hospital death. The band was removed early in 3 patients. Mean time to follow-up was 5.2 ± 3.5 years. Overall, 32 of the 41 patients discharged from hospital with absorbable PABs did not require reoperation on the VSDs or the band, resulting in a singlestage definitive repair of 78%. Median time to absorbable PAB resorption was 7.2 months (interquartile range, 5.0-10.4). Freedom from reoperation related to residual VSDs or PAB obstruction was 78% (95% CI: 61-87%) at 10 years. CONCLUSIONS: The use of absorbable polydioxanone PABs is an effective method of reducing reoperations for multiple VSDs. Their use should be incorporated in the surgical strategy for repair of muscular and residual VSDs. [ABSTRACT FROM AUTHOR]