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It is with interest that we read Tissot and colleagues’ 1Tissot C. Aggoun Y. Beghetti M. da Cruz E.M. Sierra J. Kalangos A. The Lecompte maneuver as an alternative to reduction pulmonary arterioplasty for relief of airway compression in absent pulmonary valve syndrome (letter).Ann Thorac Surg. 2007; 83: 727Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar] letter. They have re-stated the value of the Lecompte maneuver in congenital cardiac conditions associated with hypertensive dilatation of the pulmonary arteries resulting in bronchial compression; in our article we included such a patient with totally anomalous pulmonary venous drainage (APVS). Currently we selectively use reduction arterioplasty, and we certainly have seen cases in which a good result was achieved using the Lecompte maneuver in isolation. We would suggest that the Lecompte maneuver and pulmonary reduction arterioplasty should be considered as complementary procedures rather than mutually exclusive in APVS [2Nölke L. Azakie A. Anagnostopoulos P.V. Alphonso N. Karl T.R. The Lecompte maneuver for relief of airway compression in absent pulmonary valve syndrome.Ann Thorac Surg. 2006; 81: 1802-1807Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar]. Although we accept that changing the mediastinal geometry (ie, the relationship between the great arteries and the bronchus, and the stretching of the pulmonary arteries) by means of the Lecompte maneuver is important, reduction of the pulmonary artery flow and pressure associated with complete repair in some patients is also important. In cases wherein the pulmonary artery diameter is several standard deviations greater than normal, an anterior reduction pulmonary arterioplasty adds little to the length or complexity of the procedure and should avoid a further period on cardiopulmonary bypass if the airway is found to be significantly compromised on a postoperative bronchoscopy. It is with interest that we read Tissot and colleagues’ 1Tissot C. Aggoun Y. Beghetti M. da Cruz E.M. Sierra J. Kalangos A. The Lecompte maneuver as an alternative to reduction pulmonary arterioplasty for relief of airway compression in absent pulmonary valve syndrome (letter).Ann Thorac Surg. 2007; 83: 727Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar] letter. They have re-stated the value of the Lecompte maneuver in congenital cardiac conditions associated with hypertensive dilatation of the pulmonary arteries resulting in bronchial compression; in our article we included such a patient with totally anomalous pulmonary venous drainage (APVS). Currently we selectively use reduction arterioplasty, and we certainly have seen cases in which a good result was achieved using the Lecompte maneuver in isolation. We would suggest that the Lecompte maneuver and pulmonary reduction arterioplasty should be considered as complementary procedures rather than mutually exclusive in APVS [2Nölke L. Azakie A. Anagnostopoulos P.V. Alphonso N. Karl T.R. The Lecompte maneuver for relief of airway compression in absent pulmonary valve syndrome.Ann Thorac Surg. 2006; 81: 1802-1807Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar]. Although we accept that changing the mediastinal geometry (ie, the relationship between the great arteries and the bronchus, and the stretching of the pulmonary arteries) by means of the Lecompte maneuver is important, reduction of the pulmonary artery flow and pressure associated with complete repair in some patients is also important. In cases wherein the pulmonary artery diameter is several standard deviations greater than normal, an anterior reduction pulmonary arterioplasty adds little to the length or complexity of the procedure and should avoid a further period on cardiopulmonary bypass if the airway is found to be significantly compromised on a postoperative bronchoscopy. The Lecompte Maneuver as an Alternative to Reduction Pulmonary Arterioplasty for Relief of Airway Compression in Absent Pulmonary Valve SyndromeThe Annals of Thoracic SurgeryVol. 83Issue 2PreviewWe read with great interest the article by Nölke and colleagues 1] describing the benefits of the Lecompte maneuver for relief of airway compression in absent pulmonary valve syndrome. Full-Text PDF