Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Apr;35(2):211-214.
doi: 10.1007/s12055-018-0751-y. Epub 2018 Oct 22.

Bulboventricular foramen enlargement: an alternative surgical approach

Sachin Talwar  1   2 , Bharat Siddharth Chigurupati  1 , Sukhjeet Singh  1 , Shiv Kumar Choudhary  1
Affiliations
Case Reports

Bulboventricular foramen enlargement: an alternative surgical approach

Sachin Talwar et al. Indian J Thorac Cardiovasc Surg. 2019 Apr.

Abstract

Bulboventricular foramen (BVF) enlargement is often required to enlarge a restrictive interventricular communication in patients with univentricular hearts (UVH) to prevent the development of systemic ventricular outflow tract obstruction (SVOTO). We describe an alternative surgical technique through the transected pulmonary artery without an atriotomy, ventriculotomy or aortotomy that was successfully performed in a patient with double inlet left ventricle (DILV) with malposed great arteries (MPGA) and a restrictive BVF.

Keywords: Bulboventricular foramen; Single ventricle; Subaortic obstruction.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Preoperative CT angiography axial cut section showing 3-mm BVF. BVF, bulboventricular foramen
Fig. 2
Fig. 2
Sketch diagram showing divided main pulmonary artery and transpulmonary approach to the BVF enlargement. BVF, bulboventricular foramen; MPA, main pulmonary artery
Fig. 3
Fig. 3
a Intraoperative TEE showing intact atrial septum. b Intraoperative TEE showing restrictive VSD (BVF) and hypoplastic RV, with moderate Left AVVR. c Intraoperative TEE post-surgery showing post atrial septectomy status. d Intraoperative TEE post-surgery showing enlarged BVF. BVF, bulboventricular foramen; IAS, interatrial septum; RV, right ventricle; LV, left ventricle; RA, right atrium; LA, left atrium
See this image and copyright information in PMC

References

    1. Talwar S, Arora Y, Singh S, Airan B. An alternative technique of atrial septectomy during bidirectional superior cavopulmonary anastomosis. J Card Surg. 2017;32:659–661. doi: 10.1111/jocs.13205. - DOI - PubMed
    1. Alsoufi B. Management of the single ventricle and potentially obstructive systemic ventricular outflow tract. J Saudi Heart Assoc. 2013;25:191–202. doi: 10.1016/j.jsha.2013.05.003. - DOI - PMC - PubMed
    1. van Son JA, Reddy VM, Haas GS, Hanley FL. Modified surgical techniques for relief of aortic obstruction in {S,L,L} hearts with rudimentary right ventricle and restrictive bulboventricular foramen. J Thorac Cardiovasc Surg. 1995;110:909–915. doi: 10.1016/S0022-5223(05)80157-6. - DOI - PubMed
    1. Fraser CD Jr. Management of systemic outlet obstruction in patients undergoing single ventricle palliation. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2009;12:70–75. - PubMed
    1. Cheung HC, Lincoln C, Anderson RH, et al. Options for surgical repair in hearts with univentricular atrioventricular connection and subaortic stenosis. J Thorac Cardiovasc Surg. 1990;100:672–681. - PubMed

Publication types

LinkOut - more resources