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Ann Thorac Surg 1997;64:502
© 1997 The Society of Thoracic Surgeons

Discussion

Discussion

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

See also page 495.

DR PEDRO J. DEL NIDO (Boston, MA): Doctor Karl, this is a very nice presentation of a very difficult problem.

Wouldn't it make more sense to try to close the VSD through the aortic root? You have the two great vessels divided, you have taken the coronary arteries off, and you are looking straight down at the morphologic right ventricle. Do you think this approach is easier and perhaps has a lower incidence of AV block?

The other question I had for you is, you are referring to a relatively small subpopulation of children with L-TGA. Many of these children have LVOTO; that is, subpulmonary obstruction. What is your approach to these children, and do you advocate the anatomic repair, which is to divert the LV flow through the VSD to the aorta?

DR KARL: Thank you. I think that the suggestion about the approach to the VSD is a good one, and the experience with the Ilbawi operation supports the concept. I believe that the incidence of heart block is much lower when the VSD is closed from the anatomic right side of the septum, which one could do . . . [Full Text of this Article]


Related Article

Senning Plus Arterial Switch Operation for Discordant (Congenitally Corrected) Transposition
Tom R. Karl, Robert G. Weintraub, Christian P. Brizard, Andrew D. Cochrane, and Roger B. B. Mee
Ann. Thorac. Surg. 1997 64: 495-502. [Abstract] [Full Text]





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