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Abstract
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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References
- Anastomosis of superior vena cava and pulmonary artery in the surgical treatment of certain congenital defects of the heart.J. Thoracic Surg. 1959; 37: 693
- Cavopulmonary anastomosis.Thorax. 1960; 15: 165
- Surgical considerations for treatment of congenital tricuspid atresia and stenosis.J. Thoracic Surg. 1962; 43: 97
- Superior vena cava to pulmonary artery shunt for tricuspid atresia in an infant.Surgery. 1961; 49: 205
- Circulatory by-pass of right heart. I. Preliminary observations on direct delivery of vena caval blood into pulmonary arterial circulation: Azygos vein-pulmonary artery shunt.Yale J. Biol. & Med. 1954; 27: 147
- Circulatory by-pass of the right side of the heart. IV. Shunt between superior vena cava and distal right pulmonary artery. Report of clinical application.New England J. Med. 1958; 259: 117
- Circulatory by-pass of the right heart. III. Some observations on long-term survivors.Surgery. 1958; 43: 184
- A new method for the treatment of congenital heart disease associated with impaired pulmonary circulation. An experimental study.Acta med. scandinav. 1956; 154: 151
- Vena cava-pulmonary artery anastomosis for vascularization of the lung.J. Thoracic Surg. 1958; 35: 440
- Vena cava-pulmonary artery anastomosis. III. Successful operation in case of complete transposition of great vessels with interatrial septal defect and pulmonary stenosis.J. Thoracic Surg. 1959; 38: 166
- Surgical palliation in patients with Ebstein's anomaly and congenital hypoplasia of the right ventricle.J. Thoracic Surg. 1960; 40: 310
Article info
Publication history
Received:
November 3,
1961
Footnotes
☆Aided by a Dominion-Provincial Health Grant.
Identification
Copyright
© 1962 Published by Elsevier Inc.
