Research Article| Volume 52, ISSUE 3, P513-519, September 1962

Cavopulmonary anastomosis in the management or certain irreparable congenital heart lesions

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      Following cavopulmonary anastomosis, the superior vena cava blood perfuses directly through the right lung. In cyanotic heart disease with reduced pulmonary flow and complete mixing within the heart, such an anastomosis will increase pulmonary flow and decrease the total heart work. Oxygenation is further improved by directing venous rather than mixed blood to the pulmonary artery.
      This procedure was performed on 11 children with irreparable congenital heart lesions. Five had tricuspid atresia with pulmonary stenosis and in 4 of these postoperative improvement was gratifying, showing a rise in oxygen saturation which ranged from 17 to 22 per cent. The fifth patient had moderate improvement. In 2 patients, who had tricuspid atresia with increased pulmonary flow, the pulmonary artery was banded when the cavopulmonary anastomosis was performed. One of these infants died following thrombosis of the anastomosis and the second was clinically improved. A rise in oxygen saturation of 14 per cent followed the operation on a child with a single ventricle and pulmonary stenosis. The operation was also performed on individual patients with Ebstein's anomaly, transposition with pulmonary stenosis, and truncus arteriosus. There was little improvement in this group.
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