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Edward A. Rittenhouse
Peter B. Mansfield
Dale G. Hall
John W. Brown
Harold King
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Ann Thorac Surg 1986;42:220-228
© 1986 The Society of Thoracic Surgeons

Articles

Surgical Repair of Anatomically Corrected Malposition of the Great Arteries

Edward A. Rittenhouse, M.D.*, Lore Tenckhoff, M.D., Isamu Kawabori, M.D., Peter B. Mansfield, M.D., Dale G. Hall, M.D., John W. Brown, M.D., Harold King, M.D.

Division of Cardiovascular Surgery and Cardiology, Children's Orthopedic Hospital and Medical Center, Seattle, WA, and the Department of Surgery, Indiana University, Indianapolis, IN

* Address reprint requests to Dr. Rittenhouse, Children's Orthopedic Hospital and Medical Center, Box C5371, Room H501, Seattle, WA 98105

Anatomically corrected malposition of the great arteries ia a rare malformation in which the aorta and pulmonary artery arise from their appropriate ventricles but in an abnormal spatial relationship. This report describes 2 patients with anatomically corrected malposition who underwent closure of a ventricular septal defect and placement of a right ventricle-pulmonary artery conduit. A review of the literature indicates that surgical results have been good (92% survival) in those patients with situs solitus and atrioventricular concordance {S,D,L}. However, when there is atrioventricular discordance, that is, {S,L,D} or {I,D,L}, hypoplastic right heart structures, or both conditions, the outcome after palliative procedures has been poor (29% survival). The results of surgical treatment should improve as this entity is recognized earlier and prompt surgical treatment is undertaken.




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