A case of pulmonary artery stenosis in which evaluation of pulmonary venous flow by transesophageal echocardiography during pulmonary artery plasty contributed to the choice of operative procedure

Abstract

　A 1-month-old hypoplastic left heart syndrome (HLHS) baby who had successfully undergone Norwood surgery with RV-PA conduit at 1 month after birth developed oxygen desaturation at three weeks after Norwood surgery and was diagnosed with left pulmonary artery (PA) stenosis. PA plasty was performed, but it was difficult to wean him from cardiopulmonary bypass because of severe desaturation. Evaluation of pulmonary venous (PV) flow by intraoperative transesophageal echocardiography (TEE) helped us to identify the cause of the desaturation as right PA stenosis and to decide the operative procedure. Evaluation of PV flow by TEE is relatively easy and useful in rapidly estimating pulmonary circulation during surgery for congenital heart disease, in which the balance of pulmonary and systemic circulation is important.