{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:58:14Z","timestamp":1787504294276,"version":"build-2736575974"},"reference-count":25,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:p>Severe left outflow tract obstruction (LVOTO) is not always associated with hypoplastic left heart syndrome (HLHS). Aortic valvar atresia or complex LVOTO in the presence of a large ventricular septal defect (VSD) are a rare group of lesions that offer the possibility of biventricular repair. The Yasui procedure is the commonest surgical approach which can be performed as a primary neonatal correction or as a staged procedure with a Norwood followed by a subsequent Rastelli. This article reviews the surgical outcomes and decision-making process. Both strategies are reasonable with the trend toward staged procedure in the setting of the additional interrupted arch, with neonatal survival of &gt; 90% in the modern era and excellent long-term survival. Re-intervention is mostly related to conduit revision and the need for re-operation for LVOTO is rare. Deciding between conventional repair and the Yasui in cases of LVOTO\/VSD can be difficult and there are no uniform accepted criteria. In a typical neonate, an aortic annulus &lt; 4.5\u2005mm is generally the limit of acceptability for a conventional repair. In selected cases of LVOTO\/VSD, an alternative to the Yasui is the Ross-Konno. Retrospective comparisons between the 2 techniques are difficult due to differing patient characteristics (especially associated with mitral valve disease) but the neonatal Ross has been associated with higher early mortality.<\/jats:p>","DOI":"10.1177\/21501351221114881","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T09:04:08Z","timestamp":1662109448000},"page":"624-630","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Aortic Atresia or Complex Left Outflow Tract Obstruction in the Presence of a Ventricular Septal Defect"],"prefix":"10.1177","volume":"13","author":[{"given":"Allison J.","family":"Howell","sequence":"first","affiliation":[{"name":"Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Ontario, 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