ies ▁to ▁remain ▁perf used . ▁It ▁was ▁first ▁described ▁in ▁ 1 9 8 7 . ▁ ▁Ind ic ations ▁ ▁A ▁Y as ui ▁procedure ▁can ▁be ▁done ▁instead ▁of ▁a ▁Nor wood ▁operation ▁in ▁some ▁cases ▁of ▁L V OT ▁obst ruction ▁to ▁avoid ▁comm itting ▁a ▁child ▁to ▁a ▁single - vent ric le ▁heart , ▁or ▁it ▁can ▁follow ▁a ▁Nor wood ▁operation ▁when ▁the ▁sur geon ▁uses ▁a ▁st aged ▁approach . ▁It ▁is ▁also ▁used ▁when ▁the ▁Ross ▁procedure ▁or ▁Kon no ▁procedure ▁are ▁not ▁feas ible ▁in ▁children ▁who ▁have ▁had ▁other ▁sur ger ies ▁to ▁repair ▁co arct ation ▁of ▁the ▁a ort a ▁or ▁interrupted ▁a ort ic ▁arch . ▁ ▁Te chni que ▁ ▁The ▁Y as ui ▁procedure ▁is ▁done ▁via ▁a ▁median ▁stern ot omy ▁and ▁uses ▁card iop ul mon ary ▁by pass . ▁If ▁there ▁is ▁a ▁pat ent ▁du ct us ▁ar ter os us , ▁the ▁sur geon ▁begins ▁by ▁closing ▁it . ▁The ▁sur geon ▁then ▁connect s ▁the ▁separated ▁parts ▁of ▁the ▁a ort a ▁together . ▁The ▁sur geon ▁then ▁tran sect s ▁the ▁pul mon ary ▁ar tery ▁and ▁a ort a ▁and ▁fre es ▁them ▁from ▁surrounding ▁t issue , ▁then ▁makes ▁an ▁inc ision ▁into ▁the ▁right ▁vent ric le ▁to ▁allow ▁them ▁to ▁assess ▁the ▁vent ric ular ▁sept al ▁defect ▁and ▁remove ▁excess ▁mus cle ▁bund les ▁in ▁cases ▁of ▁extensive ▁right ▁vent ric ular ▁hy pert ro