Surgical management of left ventricle outflow tract obstruction in infants with right-dominant
unbalanced transitional atrioventricular septal defect poses difficulties. A two-month-old
infant with transitional atrioventricular septal defect and complex left ventricle
outflow tract obstruction presented in cardiogenic shock. The patient underwent successful
biventricular repair. The operative procedure included detachment of the anterior
bridging leaflet and resection of its chordal attachments. Septal myectomy was performed
with creation of an interventricular communication, followed by patch augmentation
of the left ventricular outflow tract and anterior bridging leaflet. The zone of apposition
between anterior and posterior bridging leaflets was closed. The repair resulted in
effective augmentation of the left ventricular inflow and outflow tracts.
