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Abstract
The results obtained in the surgical treatment of forty-three patients with pulmonary
stenosis are reported. Six patients died, five during operation or in the immediate
postoperative period, and one six weeks after discharge from the hospital. The causes
of death are discussed. An anastomosis was made between the innominate artery and
a pulmonary artery in three instances and between a subclavian artery and a pulmonary
artery in thirty-seven instances. No improvement was observed in four patients following
operation, due to the formation of thrombi at or adjacent to the vascular anastomosis.
The most frequent postoperative complications were (1) pleural effusion, (2) chylothorax,
and (3) brain damage from relative anoxemia. The method of approach and choice of
the systemic vessel to be used for the anastomosis are discussed. In our opinion,
most cases are best treated by making an anastomosis between the left subclavian artery
and the left pulmonary artery. Certain aspects of operative technique and anesthesia
are discussed. Experience with one patient having the Eisenmenger complex is related.
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References
- The Surgical Treatment of Malformations of the Heart in Which There Is Pulmonary Stenosis or Pulmonary Atresia.J. A. M. A. 1945; 128: 189-202
- Physiopathology and Surgical Treatment of Congenital Cardiovascular Defects; Harvey Lecture.Bull. New York Acad. Med. 1946; 22: 57-80
- Surgical Treatment of Congenital Pulmonic Stenosis.Ann. Surg. 1946; 124: 879-887
- Oxygenation Studies in Congenital Pulmonary Stenosis.Am. Heart J. 1948; 35: 940-947
- Pentothal Curare Mixture.Anesthesiology. 1947; 8: 75-79
Article info
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© 1948 Published by Elsevier Inc.
