Non-valved external conduit repair in corrected transposition of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction
Tatsuno, K.; Kikuchi, T.; Mori, K.; Murakami, Y.; Mimori, K.
Nihon Kyobu Geka Gakkai 32(6): 969-976
1984
ISSN/ISBN: 0369-4739 PMID: 6491412 Document Number: 238653
Nonvalved external conduit bypass between the venous ventricle and the main pulmonary artery was performed in 3 patients with corrected transposition of the great arteries (CTGA) associated with ventricular septal defect (VSD) and pulmonary stenosis or atresia, and fairly satisfactory results were obtained. All patients had subaortic VSD, which was closed with a Dacron patch through aortic incision. Pulmonary stenosis was released by pulmonary valvotomy and resection of subannular fibrous tissue. However, stenosis remained in all patients and external bypass was required. The patient no. 3 was associated with situs inversus and regurgitation of the venous atrioventricular valve. This regurgitation was repaired by suture of the cleft in the anterior leaflet. Postoperative course was uneventful, except the patient no. 3, who suffered low cardiac output syndrome in the early postoperative period. Postoperative catheterization revealed that systolic pressure in the venous ventricle was < 45 mmHg, and systolic pressure gradient between the venous ventricle and the pulmonary artery was trivial. Therefore, in CTGA associated with severe pulmonary stenosis, the nonvalved external conduit bypass is an available method for reconstruction of the venous ventricular outflow tract, even though the regurgitation through the nonvalved conduit remains after surgery.