A lexicon of common surgical procedures for congenital heart disease

CONGENITAL/FETAL

A Lexicon of Common Surgical Procedures Congenital Heart Disease

CARDIOLOGY

for

Douglas S. Segar, MD, Indianapolis, Indiana

As an aid to interpreting the literature and understanding the anatomy and physiology of surgical correction of congenital heart diseases, the following tabulation (Table 1) may be useful:

Common Surgical Procedures for Connenital Heart Disease Procedure

Description

Intent

Result

Blalock-Tausstg Central shunt

Subclavian artery to pulmonary artery anastomosts Condmt or anastomosts between aorta and pulmonary artery Pulmonary artery end-to-stde anastomosts to aorta, valved conduct between RV and mam pulmonary artery Anastomoas or conduct between nght atrium and pulmonav aner) WC to pulmonary artery anastomosis Transectton of aorta and pulmonary artery wth rermplantation onto the proper ventricles, coronaq arteries retmplanted WC to pulmonar); attq anastomosts \\ith hafle placed in nght atrium so that IVC blood flow goes across ASD to left heart Replacement of aorttc valve with aoruc valve annular enlargement Atnal swtch wtth mtraatnal baffle made of pencardtum

PAL PAL

Increases pulmonary Increases pulmonary

COR

Increases blood flow to aorta and pulmonary artery when there ts aorttc stenosis and two wntncles; reestabhshes RV to PA contmmty Increases pulmonary blood flow m cases of univentncular heart or tricuspid atresra Increases pulmonary blood flow Creates normal relationshrp between the ventricles and great artenes in transpositton

PAL

Potts PA band Rashkmd

Pulmonary artery anastomosts to aorta, condmt from aorta to mam pulmonary artery Descendmg aorta to pulmonary artery shunt Constncttve band around mam pulmonary artery Atnal septostomy wrth catheter balloon

Rastelll

Valved condutt

COR

Ross

Pulmonary

Sennmg

Atnal switch [laps

Waterston

Ascending

Damus-Kaye-Stat4

Fontan Glenn tbtdtrecttonal Glenn) Anenal swtch or Jatene

Hemi-Fontan

Konno Mustard

Norwood

(first stage)

from RV to PA, closure

autograft wth

of VSD

to aorta Pulmonary mtraatnal

bame made of atnal wall

aorta to nght pulmonary

KC

homograft

anastomosts

CURREXTJOURNAL

REVIEW

46

PAL PAL COR

blood flow blood flow

PAL

Increases pulmonary blood flow and sets the stage for eventual complete Fontan

COR

Alle\lates suhaontc obstructron and replaces abnormal aorttc valve Reestabhshes proper flow sequence to pulmonary artery and aorta m D-transposinon of the great artenes Increases flow to aorta for subaornc obstruction with single ventricle Increases pulmonary flow (rarely done anymore) Decreases pulmonary flow Increases mvtmg of blood for transposttton of the great arteries or tncusptd atresta Increases pulmonar); flow, may reestablish proper sequence of flow to aorta and pulmonary artery Correction for aornc stenosts. Avotds mechamcal and broprosthettc valve Reestabltshes proper flow sequence to pulmonary artery and aorta in transpositton of the great artenes Increases pulmonary blood flow (rarely done anymore)

COR

PAL PAL PAL

COR COR

PAL

March/Aprd

1996