CAUSE OF KINKING OF RIGHT PULMONARY-ARTERY IN WATERSTON ANASTOMOSIS - GROWTH PHENOMENON

Abstract

The case is presented of an infant, referred at the age of 8 h, who underwent a Waterston anastomosis for pulmonary atresia with intact ventricular septum and a hypoplastic right ventricle. Angiographic studies performed 3 days and 12 mo. after the procedure clearly demonstrated that kinking was not present soon after the operation but developed later. Kinking of the right pulmonary artery is a widely recognized complication of the Waterston anastomosis. Data show that severe kinking occurs more frequently in infants operated during the 1st yr of life than in those treated after 1 yr of age. These data and the case herein support the hypothesis that the kinking occurring after the Waterston anastomosis develops because of growth and realignment of the great arteries. Because of this and other problems encountered, it is recommended that either primary correction or, in case of an uncorrectable cardiac defect, a Blalock-Taussig shunt should be performed.