J.Jpn. Surg. Soc.. 84(9): 804-807, 1983

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Report on the annual meeting

TOTAL CORRECTION OF COMPLETE TRANSPOSITION OF THE GREAT ARTERIES (d-TGA) AND FONTAN PROCEDURE FOR TRICUSPID ATRESIA(TA)

Since 1975, 87 patients underwent total correction consisting of 35 cases of Mustard procedure with 6 early deaths (17.1%), 36 Senning with 2 deaths (5.6%), 12 Rastelli operations with 4 deaths (33.3%), and Jatene procedure on 4 cases without mortality. Sixteen patients out of 63 early survivors following intraatrial repair resulted in fatal outcome. In 17 with a modified senning procedure with a pedicled autologous pericardial patch on the functional left atrium, 8 died of pulmonary venous obstruction caused by thicking and calcification of pericardium. However, no death was seen in 17 patients with original senning procedure. Right ventricular function remained poor in cases with intraatrial repair and accounted for relatively poor long-term results. Although Rastelli operation carried high early mortality, late death was seen only in 1. Jat ene procedure was performed in 4 ranging in ages from 5 months to 6 years without mortality.
Fontan operation was done on 22 patients with 2 early deaths and no late death in tricuspid atresia. Average cardiac index after surgery was 2.6±0.6. Cardiac index showed close correlation with preoperative cross sectional area of both pulmonaty artery divided by body surface area (PA-index), but had poor correlation with right atrial pressure or left ventricular volume.

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