Use of a valved conduit from right atrium to pulmonary artery for "correction" of single ventricle.

Abstract

Nine patients with single ventricle and pulmonary stenosis were treated by using a valved conduit from right atrium to the main pulmonary artery. The patient's own mobilized pulmonary valve was used in one patient and fresh, adult-sized aortic homograft in the remaining eight. Two additional unstented homografts were inserted at the entrance of both superior and inferior venae cavae in four patients. A pericardial baffle was used to direct pulmonary venous blood to both atrioventricular valves in three, and the tricuspid valve was oversewn in six. L-transposition of the great arteries was present in five patients and D-transposition in one. Tricuspid valve hypoplasia was present in one and mitral hypoplasia in one. The age at operation was 4 months to 36 years. All patients were severely incapacitated with arterial oxygen saturation varying from 28% to 76%. Four patients died within the first week after operation, the remaining five patients derived excellent symptomatic improvement. Repeat cardiac catheterization, performed in five patients, showed a mean right atrial pressure varying from 8 to 17 mm Hg and a prominent right atrial A wave, measuring 10 to 25 mm Hg, with evidence of good function of the homografts at the entrance of the venae cavae. The arterial oxygen saturation varied from 88% to 97%.