Original communication| Volume 24, ISSUE 2, P355-370, August 1948

Experiences in the surgical treatment of pulmonary stenosis

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      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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