Cardiology | Clinical Services | Cardiothoracic Surgery

The Cardiothoracic Surgery Department, together with the Pediatric Cardiologists supply surgical options for virtually all forms of congenital heart disease that require repair or correction. Two Pediatric Cardiothoracic Surgeons perform all of the cardiac operations at St. Louis Children's Hospital. After your pediatrician has referred your child to one of the cardiologists and surgical intervention seems appropriate, one of the Surgeons will be consulted and the operation scheduled. All families will meet with the Surgeon, usually at the time of admission on the day before the operation. However, a prior meeting can also be arranged with the particular surgeon if necessary.

The Cardiothoracic Surgery and Cardiology services rely on the principal that anatomical correction for any particular cardiac abnormality is the ideal end-point for repair of congenital cardiac defects. However, given the complexity of some of the defects and the difficulty of achieving that end, other palliative and supportive procedures are frequently employed in the course of surgical correction. These procedures may include the following:

  • Norwood, Glenn and Fontan procedures for complex single ventricle defects such as Hypoplastic Left Heart Syndrome.
  • Pulmonary artery banding to control pulmonary blood flow, pending further corrective surgery.
  • Systemic to pulmonary shunts (such as Blalock Taussig shunts) to increase pulmonary blood flow, pending further corrective surgery.
  • Extra-Corporeal Membrane Oxygenation (ECMO) support for severe myocardial dysfunction.
  • Placement of long-term indwelling intra-venous catheters for prolonged antibiotic therapy or nutritional support, if necessary.

Surgical Operations Performed at St. Louis Children's Hospital

(This listing is not intended to be a complete summary of all types of surgeries offered.)

Repair of Septation Defects

  • Atrial septal defect
  • Ventricular septal defect
  • Atrioventricular canal defect

Repair of Valve Lesions

  • Aortic valve replacement, including the Ross procedure
  • Pulmonary valve replacement
  • Mitral valve replacement
  • Tricuspid valve replacement

Repair of Aortic Arch Abnormalities

  • Coarctation of the Aorta and Arch Hypoplasia
  • Supravalvar Aortic Stenosis in Williams and Williams-like syndromes
  • Interrupted Aortic Arch

Repair of Cyanotic Heart Lesions

  • Tetralogy of Fallot
  • Tetralogy of Fallot with pulmonary atresia and aorto-pulmonary capillaries
  • Ebstein's anomaly

Repair of Transposition of the Great Arteries

  • Arterial Switch Procedure
  • Rastelli procedure

Repair of Ventricular Outlet Obstruction

  • Sub-Aortic Membrane and / or Muscle Resection
  • Double Chambered Right Ventricle

Repair of Abnormal Coronary Arteries

  • Reimplantation of Anomalous Left Coronary Artery
  • Coronary Artery Fistula

Repair and Palliation of Complex Single Ventricle Defects

  • Hypoplastic Left Heart Syndrome including Unbalanced Atrioventricular Canal, right ventricle dominant
  • Tricuspid and / or Pulmonary Atresia
  • Mixed single ventricle lesions associated with Heterotaxy Syndrome

Heart Transplantation

  • Performed for end-stage heart disease (both congenital and acquired)

Repair of Anomalous Pulmonary Venous Return

  • Total Anomalous Pulmonary Venous Return
  • Associated defects such as Scimitar Syndrome with Anomalous Venous Return

Repair of Vascular Anomalies

  • Patent Ductus Arteriosus
  • Vascular Rings

Repair of Cardiac Defects Associated with Various Genetic Disorders

  • Down Syndrome: Atrioventricular Canal Defects
  • Marfans Syndrome: Aortic Valve and Aortic Root Surgery
  • Williams and Associated Syndromes: Supra-Valvar Aortic Stenosis and Branch Pulmonary Stenosis

Electrophysiolgy Related Procedures

  • Pacemaker Implantation
  • Internal Cardiac Defibrillator Implantation
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