J.Jpn. Surg. Soc.. 80(11): 1269-1273, 1979

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Report on the annual meeting

TOTAL CORRECTION OF TETRALOGY OF FALLOT AFTER WATERSTION ANASTOMOSIS

The ascending aorta-right pulmonary artery anastomosis has been widely used in palliation of cyanotic heart disease. We have performed this operation for 88 patients with Tetralogy of Fallot, and 41 patients of whom have received complete total correction after this procedure. This shunt operation has excellent effects to give the adequate blood flow for the severe cyanotic disease, but may result in stenosis and occlusion of right or left horizontal pulmonary artery from the development of ascending aorta or from the inproper anastomosis behind the aorta in 31 (66%) of 47 cases by angiography prior to total correction. We have repaired of pulmonary stenosis or kinking in 5 of 41 cases at the time of total correction of Tetralogy of Fallot after Waterston anastomosis.
A new approach was utilized for the repair of pulmonary stenosis at the site of left horizontal pulmonary artery by cutting the anastomotic orifice from the inside of ascending aorta and this enlarged orifice was closed with Gore-Tex prosthesis at the time of total correction.
The indication of Waterston operation should be carefully decided and the total correction must be performed within 3-4 years after this type of operation.

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