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Intracardiac repair for anomalous pulmonary venous connection of right lung to inferior vena cava
ABSTRACTS had successful open correction after initial palliative surgery. Both these patients had pulmonary valvulotomy and shunts and in both cases it appeared that the right ventricle had grown during the 2 yr between palliation and successful correction. Correction was accomplished by enlargement of the right ventricle and reconstruction ok its outflow tract with a single cusp-bearing aortic homograft. These represent the first known correction of this difficult lesion and substantitate the hope that at least some of these hypoplastic ventricles can grow if the patient can survive. -_7ens G. Rosenkmnfz Repair of Transposition of the Great Arteries by Transposition of Venous Return. G. K. Danielson, D. D. Mair, P. A. Ongley. t?. B. Wallace, and D. C. McGoon. J. Thorac. Cardiovasc. Surg. 61: 96-102 (January), 1971. This paper reports the results of 69 patients with transposition who underwent correction at the Mayo Clinic from 19641969. Twenty-five patients had intact ventricular septa; only three did not survive correction. Twenty-nine patients with ventricular septal defects and without pulmonic stenosis were treated; 16 died. Fifteen patients with pulmonic stenosis were managed; six died. Death in the second group seemed related to pulmonary hypertension; in the last group, to inadequately relieved f ulmonic obstruction. The authors now prefer repair of transposition of the great vessels with VSD and subvalvular pulmonic stenosis by Rastelli’s procedure: diversion of the left ventricle to the aorta (through the VSD) and aortic homograft reconstruction of the right ventricular outflow tract. (Six cases done; all survived.) -7en.s G. Rosenkrnnfz Intracardiac Repair for Anomalous Pulmonary Venous Connection of Right Lung to Inferior Vena Cava. J. W. Murphy, A. R. Kerr, and J. W. Kirklin. Ann. Thorac. Surg. 11:38-42 (January), 1971 This paper describes a technique for repair of this lesion wherein the orifice of the right pulmonary vein is shunted through an atria1 septal defect created at the fossa
91 ovalis by use of a pericardial patch. The right atrium is then closed. This seems easier than division of the anomalous vein for replantation in the left atrium, since this vein frequently enters the inferior vena cava at or below the diaphragm. -Tens G. Rosettkrnrrtz Long-term Result Following Correction of Total Anomalous Pulmonary Venous Connection. M. M. R. Gomes, R. H. feldt. D. C. McGoon, and G. K. Danielson. J. Thorac. Cardiovasc. Surg. 61:253-257 (February), 1971. This is a foIlow-up study of a previous report on the hospital course of 59 patients at the Mayo Clinic, 49 of whom survived correction of totally anomalous pulmonary venous drainage. All 49 patients were traced, 12 were reexamined 1-14 yr postoperatively and in 37 followup was by questionnaire. There was one later death 2 yr postoperatively, presumably from an arrhythmia. Clinically, all other patients seemed well. Only four patients had cardiac catheterization postoperatively. -7eizs G. Xose?zkrnntz Waterston Anastomosis. D. Pickering, G. A. Trusler, 1. Lipton, and J. D. Keith. Thorax 26:457-459 (July), 1971. Results before and after the age of 6 mo are compared in 40 Waterston aorticoto-pulmonary anastomoses performed at the Hospital for Sick Children, Toronto. The palliative systemic-to-pulmonary arterial anastomosis was indicated for infants with cyanotic congenital heart disease and severe pulmonary oligemia who had increasing cyanosis for hypoxic spells. Six of the 26 patients under the age of 6 mo died from noncardiac congenital abnormalities, and of the remaining 20, nine survived. In this group the Waterston anastomosis compares favorably with other shunting procedures, being easy, quick and adequate even if the pulmonary artery is small. The shunt is also easier to close at the time of total correction. In the group over 6 mo of age there was no immediate operative mortality, but one of the 14 patients died at home from “cardiac failure” and two others died from anomalies of the urinary tract.
91 ovalis by use of a pericardial patch. The right atrium is then closed. This seems easier than division of the anomalous vein for replantation in the left atrium, since this vein frequently enters the inferior vena cava at or below the diaphragm. -Tens G. Rosettkrnrrtz Long-term Result Following Correction of Total Anomalous Pulmonary Venous Connection. M. M. R. Gomes, R. H. feldt. D. C. McGoon, and G. K. Danielson. J. Thorac. Cardiovasc. Surg. 61:253-257 (February), 1971. This is a foIlow-up study of a previous report on the hospital course of 59 patients at the Mayo Clinic, 49 of whom survived correction of totally anomalous pulmonary venous drainage. All 49 patients were traced, 12 were reexamined 1-14 yr postoperatively and in 37 followup was by questionnaire. There was one later death 2 yr postoperatively, presumably from an arrhythmia. Clinically, all other patients seemed well. Only four patients had cardiac catheterization postoperatively. -7eizs G. Xose?zkrnntz Waterston Anastomosis. D. Pickering, G. A. Trusler, 1. Lipton, and J. D. Keith. Thorax 26:457-459 (July), 1971. Results before and after the age of 6 mo are compared in 40 Waterston aorticoto-pulmonary anastomoses performed at the Hospital for Sick Children, Toronto. The palliative systemic-to-pulmonary arterial anastomosis was indicated for infants with cyanotic congenital heart disease and severe pulmonary oligemia who had increasing cyanosis for hypoxic spells. Six of the 26 patients under the age of 6 mo died from noncardiac congenital abnormalities, and of the remaining 20, nine survived. In this group the Waterston anastomosis compares favorably with other shunting procedures, being easy, quick and adequate even if the pulmonary artery is small. The shunt is also easier to close at the time of total correction. In the group over 6 mo of age there was no immediate operative mortality, but one of the 14 patients died at home from “cardiac failure” and two others died from anomalies of the urinary tract.