[A successful staged complete repair in a neonate with coarctation of aorta, ventricular septal defect, and left ventricular outflow tract obstruction--a new palliative operation].

An eight day old neonate with coarctation of aorta (CoA), ventricular septal defect (VSD), and severe left ventricular outflow tract obstruction (LVOTO) underwent a successful staged repair following a new palliative operation, which comprised aortic arch reconstruction, PTFE bypass graft between main pulmonary artery and descending thoracic aorta, and pulmonary artery banding (PAB) distal to the graft. Insertion of the bypass graft was aimed to allow enough systemic blood flow and reduces after load of ventricles after PAB. The second staged definitive operation was performed 21 days after the first operation and the procedure comprised partial resection of posterioly deviated infundibular septum via VSD, patch closure of VSD, and division of the graft. No evidence of progression of LVOTO was noted until the second stage operation despite the tight PAB. This new palliative operation, which does not need aid of cardiopulmonary bypass, is particularly effective for those with LVOTO, and can be safely applied even to seriously ill neonate. Thus, for the staged repair in aortic arch obstructive disease with VSD and severe LVOTO, this procedure can be a good alternative for palliative operation.