Glossary of Childhood Onset Heart Disease
Based upon the needs and requests of our readers, we have created this glossary to provide accurate and concise information for families and individuals. The following represents a "work in progress". Please contact us to submit items you would like to see included on this page.
Surgical
Procedures
Allograft
Allograft is similar to homograft; a valve or tissue donated by a human to use as artificial material during open heart surgery.
Apical Aortic Conduit
A tube (conduit) fitted with a valve (human or pig) which is placed from the tip of the left ventricle to the descending aorta. This is one technique used to bypass severe obstruction of blood flow from the left ventricle out to the body.
Arterial Switch Operation (ASO)
An open heart procedure used to correct transposition of the great arteries and certain forms of double outlet right ventricle. In this operation, the two large blood vessels leaving the heart - the aorta and pulmonary artery - are cut and reconnected to the "correct" pumping chamber (ventricle). In addition, the small coronary arteries must be moved to the correct vessel as well. Finally, any holes (septal defects) present in the heart will be closed during the same procedure.
Atrial Baffle
A technique used in many different cardiac operations where blood flow needs to be redirected through the upper chambers of the heart. Atrial baffles are used in complex modifications of the Fontan procedure, as well as atrial-switch operations for Transposition of the Great Arteries (Senning or Mustard).
Autograft ("Ross
procedure")
The use of one of a patient’s valves in another location in the heart. The Ross procedure involves using a patient’s normal pulmonary valve to replace a diseased aortic valve. A homograft conduit is usually placed in the area where the autograft was removed.
Cardiopulmonary Bypass
Also called the "heart/lung machine", cardiopulmonary bypass is a complicated mechanical device which allows the heart to be stopped during delicate cardiac surgical procedures. Blue (oxygen poor) blood is drained from the patient to a reservoir where oxygen is added to the blood; this red (oxygen-rich) blood is then pumped back to the patient directly into the aorta. Hypothermia (lowering of the body temperature) is used in most cases.
Cardiomyoplasty
The latissimus dorsi muscle (lateral muscle in the back) is wrapped around the heart, and is "trained", with the use of a pacemaker, to augment the function of the left ventricle.
Closed Heart Surgery
An operation on the heart (or more typically the great vessels) without the need for cardiopulmonary bypass.Examples of closed heart surgery include repairs of coarctation of the aorta and patent ductus arteriosus.
Double Switch
A complex surgical procedure that involves rerouting of the venous circulation through the atria (similar to a Senning or Mustard operation) as well as an arterial switch operation. This procedure can be performed in a small percentage of patients with L-transposition ("L-TGA", or "corrected transposition") who have two ventricles and no obstruction of blood flow to the lungs. The primary advantage of this procedure is that the structural left ventricle pumps oxygen-rich blood to the body, while the structural right ventricle pumps oxygen- poor blood to the lungs.
Extracardiac Fontan
A recent modification of the Fontan operation where a circular tube is placed around the vein from the lower portion of the body (the inferior vena cava) along the side of the heart (around the outside of the atrium), connecting directly to the pulmonary arteries. The inside of the heart (atrium) is therefore not incised at the time of surgery.
Homograft
Material (usually human heart valves and arteries) donated from a human to be used during complex reconstructive surgery.
Hypothermic Circulatory Arrest
During open heart surgery, especially in neonates and young children, the body temperature can be lowered to 60-65(F) and the heart/lung machine turned off ("circulatory arrest"). This allows the surgeon to most precisely operate on a still, non-beating heart, in an operative field where cardiac structures are optimally visualized.
Maze Procedure
A surgical procedure to control atrial fibrillation and/or atrial flutter. A number of incisions are made in the atria to block the path of the arrhythmia.
Norwood Procedure
A complex surgical procedure used for hypoplastic left heart syndrome (and similar variants) where reconstruction of the absent or small aorta is accomplished by using the patient's own pulmonary artery. This allows unobstructed blood flow to be delivered to the body. As part of the Norwood procedure, the wall between the upper chambers of the heart is removed (atrial septectomy), and a small Gore-Tex tube (shunt) is inserted from the aorta to the pulmonary arteries.
Open Heart Surgery
A cardiac surgical procedure using cardiopulmonary bypass.
Rastelli Procedure
A complex open heart procedure used for children with complex congenital heart disease that usually includes (1) a ventricular septal defect, and (2) obstruction of flow to the pulmonary arteries. In this procedure, the VSD is closed with a large patch or "baffle" to direct oxygen-rich (red) blood to the aorta and then out to the body. An artificial conduit is typically inserted to direct oxygen-poor (blue) blood to the lungs. Most patients who require a Rastelli procedure have either transposition of the great arteries (TGA) or double outlet right ventricle (DORV).
Ross Procedure (also
see: Autograft)
Surgical technique utilized to manage complex obstruction or regurgitation (leakiness) of the aortic valve. The procedure involves transferring the patient's own pulmonary valve and placing it in the aortic position. Typically, a pulmonary homograft is utilized in the location left by the removed pulmonary autograft. The advantages of the Ross procedure include growth potential of the new aortic valve; Anticoagulation(blood thinners) are usually not necessary.
ThoracoscopicSurgery
Similar to arthroscopic surgery for joint surgery or laparoscopic surgery in the abdomen, thoracoscopic surgery is performed through the use of small incisions and video cameras to acomplish procedures typically done through larger open incisions.
- Other Articles in This Section
- Associated Conditions
- Cath Lab Procedures
- Imaging Techniques
- Medical Personnel /Services
- New Strategies / Techniques
- Surgical Complications
- Surgical Procedures
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