SURGICAL TREATMENT OF CONGENITAL PULMONARY STENOSIS

Abstract

181 patients, whose ages ranged from 10 weeks to 17 yrs., were operated. Surgery was refused to no child, regardless of condition, if it could be demonstrated that there was diminished blood flow to the lungs. Skillful anesthesia was particularly important with this group of patients. During operation oxygen was conserved in patients with severe cyanosis by lowering the body temp. The surgical approach in all children above 2 yrs. of age with pulmonary stenosis was through the left 4th intercostal space. If the arch of the aorta curved to the left, an aortic-pulmonary anastomosis was done. If the arch curved to the right, a subclavian-pulmonary anastomosis was done. Postoperative complications and the causes of death are outlined and discussed. The overall mortality rate (23 deaths in 181 patients) was 12.7%. The mortality rate in patients upon whom anastomoses could be performed (16 deaths in 165 patients) was 9.7%. The results in those patients who survived surgery were very satisfactory; however, too few yrs. have passed to guess intelligently the future of these children.