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The Journal of Thoracic and Cardiovascular Surgery, Vol 72, 364-370, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
AD Jatene, VF Fontes, PP Paulista, LC Souza, F Neger, M Galantier and JE Sousa
We present a new approach for anatomic correction of transposition of the
great arteries. The two coronary arteries, with a piece of the aortic wall
attached, are transposed to the posterior artery. The two aortic openings
are closed with a patch. The aorta and pulmonary artery are transected,
contraposed, ant then anastomosed. The interventricular septal defect is
closed with a patch, through a right ventriculotomy approach, because the
right ventricle is no longer part of the systemic circulation. Two
patients, aged 3 months and 40 days weighing 4,200 and 3,700 grams,
respectively, were operated upon with deep hypothermia and total
circulatory arrest. There was good recovery from the operation, with normal
cardiocirculatory conditions. Renal failure developed in the first patient,
and she died on the third postoperative day. During this time the
cardiocirculatory conditions were good. The second patient made an
uneventful recovery. Hemodynamic studies 20 days after the operation showed
complete correction of the malformation. Five and one-half months after the
operation, he weighs 7,500 grams, and his development is very good. We
believe that this operation will be reproducible by most cardiovascular
septal defect and pulmonary hypertension.
ARTICLES
Anatomic correction of transposition of the great vessels
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