Aorta to Right Pulmonary Artery Anastomosis (Waterston's Operation) for Cyanotic Heart Disease

Abstract

Thirty patients with cyanotic heart disease, including Fallot's tetralogy, transposition of the great arteries, and tricuspid atresia had Waterston's anastomosis for gross effort intolerance or cyanotic attacks. The results were good in 28. Spontaneous closure of the anastomosis occurred in one patient. There was a tendency for preferential perfusion of the right lung, and unilateral pulmonary edema occurred in nine patients. Congestive heart failure appeared when the stoma was too large. Surgical technic to avoid kinking of the right pulmonary artery has been modified, and the importance of limiting the size of the anastomosis has been emphasized. Transaortic closure of the anastomosis through the aorta at the time of definitive correction was simple in three patients. Additional Indexing Words: ComplicationsCongenital heart disease Cardiac failure Arterial oxygen saturation Pulmonary edema Timing of complete correction Transaortic closure of anastomosis 593 From the National

Waterston anastomosis: Comparison of results of operation before and after age 6 months

“…In seven children over 6 months of age, there were no deaths from cardiac failure; seven survived, one of whom had a further operation reducing the anastomosis in size. DISCUSSION Somerville et al (1969), in a series of 30 cases over the age of 11 months, reported no mortality associated with a Waterston operation. Jones, Bernhard, Litwin, Frieberg, and Gross (1969), in 61 patients over 1 year of age, reported 54 survivors.…”

“…It is also used in infants over 6 months in whom small vessels preclude a Blalock shunt or a previous shunt is insufficient and the child is too small for total correction. Because of recent reports (Somerville, Yacoub, Ross, and Ross, 1969) of excellent results with this procedure in infants all over 6 months of age, we compared the results of the Waterston anastomosis performed in infants under 6 months of age with the results obtained in children over that age. METHOD At The Hospital for Sick Children, Toronto, a Waterston anastomosis was perforned on 40 patients with cyanotic congenital heart disease and oligaemia between June 1966 and October 1969.…”

Ascending aorta-right pulmonary artery anastomosis: Waterston's operation

“…7). This condition has been described by Somerville et al (1969), who found that 50% of their cases had preferential flow to the right lung. Even if the anastomosis is performed as far back as possible and in the correct place, but excessive pulling of the right pulmonary artery is produced at the moment of clamping, then a proximal pulmonary stenosis is created with preferential blood flow to the right lung (Fig.…”

“…Because of the increasing popularity of this technique, a large number of reports have recently been published (Cooley and Hallman, 1966;Edwards, Mohtashemi, and Holdefer, 1966 ;Waldhausen et al, 1968;Somerville, Yacoub, Ross, and Ross, 1969;Pickering, Trusler, Lipton, and Keith, 1971). CLINICAL MATERIAL We present our experience with 180 patients operated upon during the period 1968-71.…”

Systemic to Pulmonary Artery Anastomosis in the First Three Months of Life

“…Most previously reported series (Cooley and Hallman, 1963;Hallman et al, 1967;Waldhausen et d, 1968;Somerville et al, 1969) of systemic-to-pulmonary artery shunts have been concerned with patients of widely varied age. Because the highest mortality of cyanotic congenital heart disease occurs in the first 3 months of life, and because treatment at this age is particularly difficult, this report is restricted to this age-group.…”