Ligation of the Main Pulmonary Artery and Systemic-Pulmonary Arterial Anastomosis

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Abstract
A new palliative operation is suggested for certain patients with transposition of the great arteries and ventricular septal defect. A systemic-pulmonary artery shunt is created, and the main pulmonary artery ligated. The operation converts transposition of the great arteries to a functional equivalent of truncus arteriosus with normal or nearly normal pulmonary blood flow, a malformation in which the functional derangement of the circulation is not as severe as it is in transposition. The hemodynamic consequences of the procedure were initially evaluated in two patients with pulmonary atresia and transposition, and both improved after shunts were created. The procedure was then carried out in a patient with transposition of the great arteries, ventricular septal defect, mild subpulmonic stenosis, and increased pulmonary blood flow. Postoperatively, the patient has exhibited considerable clinical improvement and significant elevation of arterial oxygen saturation.

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