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Ann Thorac Surg 1995;59:940-941
© 1995 The Society of Thoracic Surgeons

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Invited Commentary

INVITED COMMENTARY

Cardiothoracic Unit Great Ormond Street Hospital for Children Great Ormond St London WC1N 3JH United Kingdom

The first 20% of the full text of this article appears below.

See also page 933.

Waldman and collaborators describe a thoughtful way to investigate patients with pulmonary atresia, intact ventricular septum, and important RV-CACs. They deduce a management protocol based on surgical closure of the tricuspid valve in those patients with large RV-CACs without stenosis of the native coronary arteries.

As so often happens, this article throws some light on the management of a difficult subset of patients and at the same time adds to the confusion that has surrounded those patients for many years.

The reasons for the controversy are at least threefold. First, the spectrum of anomalies seen varies from institution to institution and appears to fit in with each management protocol. Could this reflect a lack of objective . . . [Full Text of this Article]