Portal de Periódicos da CAPES

Superior vena cava-pulmonary artery anastomosis

1974; Elsevier BV; Volume: 67; Issue: 3 Linguagem: Inglês

10.1016/s0022-5223(19)40510-2

1097-685X

Vallee L. Willman, Hendrick B. Barner, J. Gerard Mudd, Leonard F. Fagan, George C. Kaiser,

Tracheal and airway disorders

Superior vena cava-right pulmonary artery anastomosis has been used to palliate cyanotic congenital heart disease in 42 patients with the following anomalies: tricuspid atresia, 19 cases; transposition of the great vessels, 11; pulmonary atresia, 6; truncus arteriosus, 3; Epstein's malformation, 2; and atrioventricular canal with pulmonary stenosis, 1 case. Twelve of 13 operative deaths occurred in the 24 infants younger than 6 months of age. Five of 6 infants less than 1 month old died after the operation. Six late deaths were distributed among all age groups and all cardiac lesions. Although survivors were improved clinically, there is a gradual progression of cyanosis and rise of the hemoglobin level. It is clear that cava-pulmonary anastomosis should not be done in the first month of life. An ascending aorta-right pulmonary artery shunt is preferable, even in the first 6 months if the pulmonary artery is small. The cava-pulmonary anastomosis enlarges as the child grows, but increasing venous collateral may reduce its effectiveness. When complemented with a systemic-pulmonary shunt it has the potential for long-term palliation of uncorrectable congenital lesions.