The Journal of Thoracic and Cardiovascular Surgery, Vol 71, 118-122, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Mitral atresia with premature closure of foramen ovale. A rare hemodynamic cause for failure of Blalock-Taussig anastomosis to relieve inadequate pulmonary blood flow
S Friedman, LH Edmunds, M Saraclar and EM Weinstein
The clinical, hemodynamic, and surgical findings encountered in the
management of a hypoxic male infant with a rare and complex variety of
cyanotic congenital heart disease associated with inadequate pulmonary
blood flow are described. A poor clinical response to creation of a
Blalock-Taussig anastomosis led to the discovery of mitral atresia
complicated by premature closure of the foramen ovale and partially
relieved by the presence of a levoatriocardinal vein. The subsequent
creation of an atrial septal defect enhanced the function of the subclavian
artery to pulmonary artery anastomosis and provided palliative relief of
hypoxia. Some of the clinical and laboratory findings indicating the
presence of additional lesions complicating the picture of a tetralogy of
Fallot and requiring additional surgical considerations are discussed. The
experience indicates that hemodynamic as well as surgical causes may
explain the failure of a systemic artery to pulmonary artery anastomosis to
function adequately and should be sought.
