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

Alvarez-Diaz, F.; Brito, Jussara; Cordovilla, G; León, J. Villamor; Sánchez, Pedro A.; Bordiu, C Martinez

doi:10.1136/thx.28.2.152

Cited by 13 publications

(2 citation statements)

References 7 publications

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“…Two particular procedures, Waterston's ascending aorta to right pulmonary artery anastomosis and Potts' descending aorta to left pulmonary artery shunt, became widely used, but because of serious complications were discarded and replaced by the modified Blalock-Taussig shunt. However, these complications, excessive left-to-right shunt, pulmonary arterial hypertension and pulmonary artery deformities, were, almost entirely due to the redundant diameter of the anastomoses and the technical difficulties of suturing adjacent walls of the pulmonary artery and aorta together through the lateral thoracotomy [17,18]. Perforating the walls of these vessels and placing the anastomosing stent endovascularly in the setting of unaltered vascular anatomy will avoid the problems of pulmonary artery deformities related to the surgical approach.…”

Section: Aortopulmonary Anastomosesmentioning

confidence: 99%

Building foundations for transcatheter intervascular anastomoses: 3D anatomy of the great vessels in large experimental animals

Sizarov¹,

Bakker²,

Klein

et al. 2014

Interact CardioVasc Thorac Surg

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Section: Aortopulmonary Anastomosesmentioning

confidence: 99%

Building foundations for transcatheter intervascular anastomoses: 3D anatomy of the great vessels in large experimental animals

Sizarov¹,

Bakker²,

Klein

et al. 2014

Interact CardioVasc Thorac Surg

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“…The risk in recent years of shunting operations of the Blalock-Taussig and Watenton types is known, not only in toto but also according to the age of the patient at operation (1,3,6,13,15,24,30). Information of this type must be available to determine the applicability of any palliative procedure, for we know that about 35 % of persons born with tetralogy of Fallot will require surgical treatment within the first year of life and about 45 % within the first 2 years of life (5).…”

mentioning

confidence: 99%

“The Brock Operation” as Initial Palliation for the Tetralogy of Fallot

Kirklin¹,

Nojek²,

Vanini³

1979

Thorac cardiovasc Surg

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At the recent meeting (June 1978) of the European Cardiovascular Society in Lyon, France, to our surprise a number of discussants enthusiastically endorsed the use of the closed "Brock procedure" for initial palliation of the tetralogy of Fallot. In none of the centers in which we work has this procedure of closed infundibular resection and pulmonary valvotomy been done for the tetralogy of Fallot for many years. No data was presented to support the enthusiasm of the discussants, so we have reviewed the literature concerning this.The risk in recent years of shunting operations of the Blalock-Taussig and Watenton types is known, not only in toto but also according to the age of the patient at operation (1, 3, 6, 13, 15,24,30). Information of this type must be available to determine the applicability of any palliative procedure, for we know that about 35 % of persons born with tetralogy of Fallot will require surgical treatment within the first year of life and about 45 % within the first 2 years of life (5). We also know that the rist of any palliative or corrective cardiac operation done when the patient is a few months of age may be very different from that at 5 years of age.tween age and risk of operation, but such data do not exclude the possibility that the risk would be higher in the early months of life. From what we have, we can only conclude that the risk of the closed Brock procedure for initial palliation of the tetralogy of Fallot is about 16 % (70 % CL 13 %-20 %) at any age. This idea is supported by personal communication from M. Turina in Zürich, who reports a relatively recent experience with this in 24 patients with tetralogy of Fallot in the first year of life, with 3(12 %, 70 % CL 6 %-24 %) hospital deaths.We do not know from these reports whether the closed Brock procedure was used routinely or selectively. If it was used selectively, it probably was selected for patients with favorable anatomy in the right ventricular outflow tract. This makes the relatively high mortality even more impressive.Our review of the literature accumulated 903 patients with tetralogy of Fallot who underwent a palliative Brock procedure (2, 7, 8,9,11, 16, 17,18,19,22,23,26,27,28,29,31,32). 116 patients (12.8 %, 70 % CL* 11.7 %-14.1 %) died in hospital, not initially at least a strong recommendation for this procedure. The age by year of the patients at operation was given for only 165 patients, of whom 27 (16 %, 70 % CL 13 %-20 %) died in hospital (Table 1) (2,9,10, 11,17, 18, 19,23,28,29,32). We were unable to determine the risk by month in the first year of life. We do not see here a clear relation be-* Throughout this paper 70 % CL refers to 70 % confidence limits Heruntergeladen von: National University of Singapore. Urheberrechtlich geschützt.

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2003

The Natural and Modifed History of Congenital Heart Disease

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

Cited by 13 publications

References 7 publications

Building foundations for transcatheter intervascular anastomoses: 3D anatomy of the great vessels in large experimental animals

Building foundations for transcatheter intervascular anastomoses: 3D anatomy of the great vessels in large experimental animals

“The Brock Operation” as Initial Palliation for the Tetralogy of Fallot

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