October 1965

Staged Repair of Pulmonic Stenosis and Hypoplastic Right Ventricle

Author Affiliations

From the departments of pediatrics and surgery, School of Medicine, University of California.

Arch Surg. 1965;91(4):597-601. doi:10.1001/archsurg.1965.01320160051011

ISOLATED pulmonic valvular stenosis can be successfully treated by either closed or open techniques. Good results have been obtained with a transventricular valvulotome,1 under direct vision with hypothermic circulatory arrest,2 or with extracorporeal circulation.3

When severe pulmonic stenosis is associated with a diminutive right ventricular cavity, the prognosis is poor and most of these patients die in infancy.4

This report concerns two infants with this combination of anomalies and who were successfully treated by a two-stage surgical procedure. Initial closed transventricular valvotomy was performed under emergency conditions in each patient. Subsequently a definitive correction involving a more precise valvotomy and prosthetic enlargement of the right ventricular outflow tract was performed with cardiopulmonary bypass. Analysis of previous and present results suggests that prognosis is improved by a two-stage repair, consisting of an initial rapid palliative valvotomy and a later definitive procedure.

Case Histories 

Case 1.  —A 1-year-old

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