PULMONARY VALVOTOMY AND INFUNDIBULECTOMY

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Abstract
Observations are made on 92 cases of pulmonary valvotomy or infundibulectomy. The results with transventricular "blind" valvotomy in 16 cases were not considered satisfactory. The results of infundibulectomy were not fully satisfactory by transventricular or transarterial routes and such cases are better operated upon with the use of a cardiopulmonary bypass. Transarterial open pulmonary valvotomy was performed on 61 patients at normal temperatures with three deaths, and a description of the technique is given. If the gradient between the right ventricle and the pulmonary artery is not obliterated at the end of the operation, no further treatment for the infundibular obstruction is needed, provided the pre-operative lateral angiocardiogram demonstrated a fully opened outflow tract of the right ventricle and no fibrotic structure is palpable. The gradient will fall during the succeeding months with the decrease in the infundibular muscular hypertrophy.