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Ann Thorac Surg 1978;25:431-437
© 1978 The Society of Thoracic Surgeons

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Articles

Current Results with Construction and Interruption of the Waterston Anastomosis

Division of Cardiothoracic Surgery, Department of Surgery, and the Department of Pediatrics, The University of Rochester Medical Center, Rochester, NY

Accepted for publication November 18, 1977.

^* Address reprint requests to Dr. Stewart, Division of Cardiothoracic Surgery, The University of Rochester Medical Center, Rochester, NY 14642

The Waterston anastomosis was constructed in 21 infants and neonates between 1973 and 1977. Sixteen neonates were 1 week old or less and 8 were less than 24 hours old. There were 2 operative deaths, giving a hospital survival of 90%. There were 3 late deaths. All surviving infants received satisfactory palliation except 1 who required a Potts anastomosis one year later. During the same time interval, 9 other patients who had had a Waterston anastomosis underwent complete intracardiac repair. Seven of them had significant angulation of the right pulmonary artery necessitating patch reconstruction. All patients survived operation, and follow-up pulmonary angiograms demonstrated only a slight persistent narrowing of the right pulmonary artery in 2 patients. We conclude that the Waterston anastomosis can be constructed with a low operative mortality even in the severely cyanotic neonate and that it can be taken down at the time of complete repair with minimal morbidity and no mortality even if it has significantly angulated the right pulmonary artery.

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