Complete Repair of Transposition of the Great Arteries with Pulmonary Stenosis

Author:

RASTELLI G. C.1,WALLACE ROBERT B.1,ONGLEY PATRICK A.1

Affiliation:

1. From the Mayo Clinic and Mayo Foundation: Section of Surgical Research (Dr. Rastelli), of Surgery (Dr. Wallace), and of Pediatrics (Dr. Ongley), Rochester, Minnesota.

Abstract

Complete surgical correction of transposition of the great arteries associated with subvalvular pulmonary stenosis carries a high mortality rate. A new surgical technique that achieves redirection of the ventricular outflows and relieves pulmonary stenosis by bypassing it, was successfully used to repair complete transposition of the great arteries associated with ventricular septal defect (VSD) and valvular and subvalvular pulmonary stenosis in a 14½-year-old patient. The repair consists of (1) division of the pulmonary artery, the cardiac end of which is oversewn, (2) repair of the VSD with a patch in such a way as to connect the left ventricle with the aorta, and (3) reconstruction of the pulmonary artery with an aortic homograft, including the aortic valve, which is anastomosed between the distal end of the pulmonary artery and the right ventricle. A review of the cases in which the current techniques were used indicates that the location and nature of the obstruction in the left ventricular outflow tract defies successful repair in most instances. Localized ridges and diffuse hypoplastic outflow tracts are recognized causes of obstruction, but anomalies of the mitral valve commonly contribute to or are the primary cause of subvalvular obstruction.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Reference20 articles.

1. VAN PRAAGH R. VLAD P. AND KEITH J. D.: Complete transposition of the great arteries In Keith J. D. Rowe R. D. and Vlad P.: Heart Disease in Infancy and Childhood ed.

2. New York , Macmillan Co. 1967 , pp. 682 -

3. .

4. Selection of Palliative Procedures in Transposition of the Great Vessels

5. Heart Disease in Infancy and Childhood, ed. 2. New York;KEI H, J;Macmillan Co.,1967

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