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Ann Thorac Surg 1984;37:417-421
© 1984 The Society of Thoracic Surgeons

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Articles

Surgical Management of Univentricular Heart with Subaortic Obstruction

Division of Pediatric Cardiology, Department of Pediatrics, and the Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA

Accepted for publication October 28, 1983.

^* Address reprint requests to Dr. Park, Division of Pediatric Cardiology, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213

In children with a univentricular heart and a rudimentary subaortic chamber, surgical relief of subaortic obstruction caused by a restrictive bulboventricular foramen is associated with high morbidity and mortality. A 6-year-old child with a univentricular heart of the left ventricular type, a rudimentary subaortic chamber, and atresia of the left-sided atrioventricular valve had pulmonary artery banding in infancy. Severe subaortic obstruction subsequently developed. At operation, the pulmonary artery was transected and the stump was anastomosed directly to the posterior aspect of the ascending aorta, diverting left ventricular blood into the aorta through the pulmonary valve. The distal pulmonary artery was anastomosed side-to-side to the ascending aorta to provide pulmonary blood flow. Cardiac catheterization fifteen months after the operation demonstrated an excellent hemodynamic result. When the pulmonary artery is adequate in size, a bypass operation by way of an anastomosis between the ascending aorta and the pulmonary artery is a relatively safe and effective means of relieving the ventricular outflow obstruction caused by a restrictive bulboventricular foramen.

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