J.Jpn. Surg. Soc.. 80(11): 1274-1276, 1979

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Report on the annual meeting

RIGHT VENTRICULAR OUTFLOW RECONSTRUCTION BEYOND THE BIFURCATION OF PULMONARY ARTERY IN TETRALOGY OF FALLOT AND A XENOGRAFT VALVE IMPLANTATION

Problems still remain in corrective surgery of Tetralogy of Fallot associated with hypoplastic pulmonary artery. Butterfly type stenosis at the bifurcation is often accompanied with stenosis of left main pulmonary artery. Reconstruction of pulmonary artery beyond the bifurcation needs dry operative field as well as technical skill. Various methods have been tried for excessive back flow from pulmonary arteries, such as low flow perfusion, circulatory arrest or clamp of both main pulmonary arteries. We originated a new technique for it. Back flow from pulmonary arteries was successfully blocked by inflated Fogarty catheters inserted into both main pulmonary arteries. This method is easy and can be applied rapidly.
An outflow patch reconstruction in tetralogy of Fallot with absence of one pulmonary artery presented a serious risk, resulting in pulmonary hypertension, pulmonary regurgitation and right heart failure. The use of a xenograft-valved conduit has been advocated in such cases. However, reconstruction of right ventricular outflow reconstruction by a valved conduit has several disadvantages. We overcomed this problem by the outflow patch reconstruction and a pulmonary valve replacement. Ionescu-Shiley valve was used because of good annulus diameter-orifice area ratio.

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