Biomedical subjects

J Bruniaux

Publications and source records attributed to J Bruniaux.

At least 73 records · Page 4Linked to original sources

PubMed1991

Aortic atresia with normal left ventricle.

A case of single-stage repair of aortic atresia with normal-sized left ventricle and ventricular septal defect in a neonate is reported. The surgical procedure included rerouting of the left ventricular bloodstream to the pulmonary artery through the ventricular septal defect and connection of the pulmonary trunk to the aortic arch. The right ventricular outflow tract was then reconstructed with an extracardiac valved conduit. Three years after the initial operation, replacement of the valved conduit was performed uneventfully. The clinical status of the child is very satisfactory.

Aorta↗

PubMed1991

[Neonatal anatomical repair of transposition of great vessels associated with atrial septal defect. Apropos of 42 cases].

The good results obtained by anatomic correction of simple transposition of the great arteries (TGA) in the neonatal period have incited some surgical teams to widen the indications to neonates with TGA associated with ventricular septal defect (VSD). The classical management of these patients is a two stage procedure: banding of the pulmonary artery followed by detransposition, which carries a certain risk. Between January 1985 and June 1990, 42 neonates with TGA and VSD underwent a combined procedure consisting in anatomic correction of the TGA and closure of the VSD. The average age of these patients was 16 days, and the average weight was 3.3 kg. Ten patients had coarctation and 6 underwent a complete one stage correction by an anterior approach. The surgical technique consisted in closing the VSD from the right atrium in 20 patients, from the right ventricle in 11 patients and from the pulmonary artery in 11 patients, associated with detransposition of the great arteries and coronary artery reimplantation. Three children died in the preoperative period (7.1%). In two cases, death was related to malposition of the coronary artery. The third fatality was the result of haemorrhage. There has been one late death three years after surgery. Four patients have been reoperated for stenosis of the right ventricular outflow tract (1 case), recurrence of coarctation (2 cases) and stenosis of the superior vena cava (1 case) and have survived. All patients were followed up for an average period of 26.4 +/- 19 months. They are all in the NYHA Class I without treatment. One patient has mild aortic regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗

PubMed1991

[Complete repair of tetralogy of Fallot in infants under the age of 6 months. Apropos of 25 cases].

Between January 1982 and October 1988, 25 infants with Tetralogy of Fallot underwent total correction, total primary repair was carried out in 22 cases; 3 underwent correction after a palliative anastomosis. The average age was 3.7 +/- 1.6 months; the average weight was 5.06 +/- 1.41 kg and average body surface area was 0.30 +/- 0.06 m2. Nineteen patients had a regular anatomic form and 6 had an irregular form of the condition. The hospital mortality was 8% (2 cases): the mortality was nil in the regular anatomic form but 33% in the irregular anatomic forms. Twenty-one patients have been followed up for an average of 50.8 +/- 19.2 months. There were no late deaths; two patients were reoperated for a residual pulmonary stenosis; 19 patients are well and asymptomatic. Doppler echocardiography shows a residual pressure gradient between the right ventricule and pulmonary artery of 17.8 +/- 22.7 mmHg associated with a grade 1-2/4 pulmonary regurgitation. There are no residual ventricular septal defects or cases of atrioventricular block requiring permanent pacing.

Actuarial Analysis↗

PubMed1991

[Immediate and mid-term results of complete repair of truncus arteriosus during the first year of life].

Twenty five infants with truncus arteriosus underwent complete surgical correction in the first year of life between January 1984 and June 1990 at Marie Lannelongue Hospital. All had cardiac failure and pulmonary hypertension. Another severe cardiac malformation was present in 6 cases. Complete repair was carried out under cardiopulmonary bypass with moderate hypothermia. After closing the ventricular septal defect the continuity of the right ventricle and pulmonary artery was reestablished by a valved Dacron conduit with a bioprosthesis (13 patients), by an autologous pericardial conduit with the same type of prosthesis (5 patients), by a valveless conduit (1 patient) or by direct insertion of the pulmonary artery (6 patients). Eight children (32%) died shortly after surgery. Seventy one per cent of children operated in the first month of life died compared with only 17% of those operated after one month of life (p less than 0.05). The seventeen survivors have been followed up for an average of 21 +/- 22 months. Three secondary deaths were observed at 33 days, 2 and 10 months after surgery: the first child died of left ventricular failure and pulmonary vascular disease related to the complexity of the associated cardiac malformations; the other 2 deaths were unexpected. The one and three year survival rate is 54%. Pulmonary stenosis with a systolic pressure gradient of more than 30 mmHg was found in 7 patients of whom 6 had valved Dacron conduits (p less than 0.01). One child was successfully operated 60 months after the total correction and another child is on the waiting list for reoperation 69 months after the total correction.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1991

Anatomic repair of Taussig-Bing hearts.

From 1978 through 1990, 27 consecutive patients underwent anatomic repair of Taussig-Bing heart (TBH) malformation. Group 1 (seven patients) underwent intraventricular repair by rerouting of the left ventricular blood stream through a tunnel patch from the ventricular septal defect (VSD) to the aorta. Group 2 (20 patients) underwent an arterial switch with VSD closure. Indications for each type of repair were based on the following criteria: when the great vessel relation is more or less anteroposterior, repair is performed at the arterial level; when side by side, the minimal tricuspid pulmonary valve distance is evaluated; if less than aortic valve diameter or if there are abnormal tricuspid chordae, repair is performed at the arterial level; if greater, pulmonary artery banding is performed in order to wait until suitable weight for intraventricular repair. The mean age at operation was 13.2 months. Coarctation of the aorta was present in 12 patients, abnormal tricuspid chords in eight, and subaortic stenosis in seven. The great vessels were in D-transposition in 12 patients, and they were side by side in 15. Seventeen patients underwent previous palliative surgery. Early (two patients, 7.4%) and late (two patients, 8%) mortality rates were related in group 1 to subaortic stenosis and in group 2 to myocardial infarction. Mean follow-up of 40 +/- 24 months was achieved in 22 survivors. They were all in New York Heart Association (NYHA) class I, without medication. Actuarial survival and freedom from reoperation rates were, respectively, at 5 years 73 +/- 14.6% and 58 +/- 13% (70% confidence limits [CL]).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗

PubMed1991

Obstructed total anomalous pulmonary venous return. Toward neutralization of a major risk factor.

Among 57 neonates undergoing repair of total anomalous pulmonary venous return with severe pulmonary venous obstruction from 1980 through 1989, date of operation (1980 to 1984), preoperative hemodynamic instability, and failure to monitor pulmonary artery pressure postoperatively were risk factors for death. Thus, among the 30 patients having repair between 1985 and 1989, the 55-month survival rate including hospital deaths was 83%.

Blood Pressure↗

PubMed1991

Anatomic correction of transposition of the great arteries with ventricular septal defect. Experience with 118 cases.

One hundred eighteen patients, 100 with transposition of the great arteries plus ventricular septal defect and 18 with double-outlet right ventricle and subpulmonary ventricular septal defect have undergone arterial switch and patch closure of the ventricular septal defect since February 1983. In transposition of the great arteries the ventricular septal defect was perimembranous in 70 cases, trabecular in 28, and infundibular in 10. Eleven patients had multiple ventricular septal defects. In addition to 18 patients with double-outlet right ventricle, malalignment of the conal septum was present in 19 cases. Coronary type A distribution was recognized in 79 cases, type C in one, type D in 24, and type E in 14. Great arteries were side by side in 19% of cases. Aortic coarctation was present in 31 cases, and subaortic obstruction in 9. Age at operation ranged from 4 days to 4 years (mean, 3.5 +/- 8.3 months), and mean weight was 4.0 +/- 1.6 kg. Thirty-seven infants were younger than age 1 month. Thirty-six patients underwent previous operations: pulmonary artery banding alone (n = 13), pulmonary artery banding and coarctation repair (n = 13), and coarctation repair alone (n = 10). Mean time between the first procedure and the switch was 2.2 months. Six patients with aortic coarctation underwent one-stage repair, through median sternotomy, aortic reconstruction, closure of the ventricular septal defect, and arterial switch. Perioperative mortality was 13.5% (70% confidence limit 10% to 17.6%, n = 16). It was directly related to coronary artery kinking in 50% of deaths and to anatomy and size discrepancy of the great arteries in the remaining deaths. Univariate analysis could not find any significant risk factor of in-hospital mortality. Mean follow-up of 30.3 +/- 23.5 months was achieved in all but 2 survivors. There was one late death. Ten patients underwent 11 reoperations for recoarctation (n = 1), pulmonary stenosis (n = 7), residual ventricular septal defect (n = 2), and stenosis of superior vena cava (n = 1). Two patients needed a permanent pacemaker. Actuarial survival and freedom from reoperation at 5 years were 84.5% +/- 3.6% and 85.7% +/- 4.6%, respectively. We conclude that anatomic correction of complex transposition is a safe method that offers good early and midterm results.

Child, Preschool↗

PubMed1990

Post cardiac surgery phrenic nerve palsy in pediatric patients.

From January 1978 to December 1988, 109 phrenic nerve paralyses (PNP) occurred in a total of 9149 cardiac operations performed in a population of patients younger than 15 years old (1.2%) whose age varied from 1 day to 15 years old and mean weight was 11.3 +/- 8.7 kg. PNP was diagnosed in 43 patients after closed procedures (1.2% of 3509 procedures) and in 66 patients after open heart operations (1.2% of 5640 operations). PNP was right sided in 49 cases and left sided in 60 cases. Open heart operations that predisposed to PNP were those which needed harvesting of autologous pericardium (P less than 0.0001) and wide exposure of the great vessels. The modified right Blalock-Taussig shunt was the main cause of PNP in closed procedures (P less than 0.02). Small children tolerated PNP less well. They needed longer ventilatory support (P less than 0.0005) and developed more respiratory complications. Seventeen children underwent plication of the affected hemidiaphragm and could be subsequently extubated. It is concluded that for prevention of PNP, a high level of attention should be exercised in neonates and small children, particularly when pericardium is harvested or when exposure needs extensive dissection of the great vessels and thymus resection, or at reoperation. We also prefer to avoid the use of iced slush lavage. PNP, when symptomatic, is best managed by continuous positive airway pressure (CPAP) ventilation. Diaphragmatic plication is recommended when after 2-3 weeks there is no recovery of diaphragmatic function or when there are troublesome respiratory complications.

Adolescent↗

PubMed1990

[Obstruction of total anomalous pulmonary venous drainage. Factors influencing improvement in surgical results].

Of 107 patients operated for total anomalous pulmonary venous drainage (TAPVD) at Marie-Lannelongue Hospital between January 1980 and November 1989, 57 had severe pulmonary venous obstruction. The average age of the patients at operation was 13.6 days and their average body weight was 3.2 kg. Twenty eight patients had an infracardiac, 23 patients a supracardiac, 2 patients an intracardiac and 4 patients a mixed type of TAPVD. The diagnosis of pulmonary venous obstruction was made on the findings of low cardiac output and pulmonary hypertension exceeding the systemic blood pressure, and on the results of angiography and Doppler echocardiography. Seventy five per cent of patients were admitted in Class IV of the NYHA Classification. Since 1985, treatment has been directed towards prevention of pulmonary hypertension. Echocardiographic diagnosis is considered sufficient for posing the surgical indication. Surgery should be performed before degradation of the patient's clinical condition or after a short period of stabilisation. The prevention of hypertensive crises in the postoperative period depends on continuous monitoring of pulmonary pressures. This approach has considerably improved our surgical results as the mortality rate has fallen from 59 p. 100 (1980-1984) to 13.3 p. 100 (1985-1989) (p less than 0.005). In conclusion, obstruction of the pulmonary veins in TAPVD is no longer considered to be a poor prognostic factor, providing measures are taken to prevent pulmonary hypertension before, during and after surgery.

Actuarial Analysis↗

PubMed1990

[Anatomic correction of simple transposition of the great vessels during the neonatal period. 5 years' experience in 235 children].

From March 1984 to August 1989, anatomic surgical correction was performed on 235 newborn infants (2 to 32 days old, mean 8.5 +/- 4) with simple transposition of the great arteries. Ninety-four percent of the patients underwent balloon atrial septostomy before the operation. The anatomy of the coronary arteries according to the Yacoub classification was as follows: type A, 160 patients (68%); type B, 5 patients (2%); type C, 11 patients (5%); type D, 41 patients (17%); and type E, 18 patients (8%). Coronary artery relocation was performed according to the Yacoub technique with some modifications, and the pulmonary artery reconstruction was done using the Lecompte manouver in association with a pericardial patch. The perioperative mortality rate was 8.9 percent for the entire series, significantly higher for the type C (46%, p less than 0.01) and significantly lower for the type D (0%, p less than 0.05). Seven patients were lost of follow-up. The follow-up ranged from 1 to 63 months (mean 21 +/- 14). Four late deaths occurred: 2 from myocardial infarction, 1 from pulmonary hypertension and one from a thrombotic occlusion of the superior Vena cava. One patient had an acute posterior myocardial infarction five months after the operation and his left ventricular contractility is normal at echocardiography three years later. Supravalvular pulmonary stenosis occurred in 17 patients but only two were operated on with no death. Mild aortic regurgitation occurred in nine patients. Ninety eight percent of the survivors have a normal life, with no cardiovascular symptoms and receive no medication.

Actuarial Analysis↗

PubMed1990

Midterm surgical results of arterial switch operation for transposition of the great arteries with intact septum.

Between April 4, 1984, and December 31, 1987, 156 consecutive neonates with simple transposition of the great arteries underwent an arterial switch operation (ASO) at our institution. Surgery was performed before the age of 15 days in 96%, and patient weight was less than 3 kg in 28%. Seventeen patients (10.9%) died after surgery. One patient was lost to follow-up. Of the 138 survivors, two died of myocardial infarction 35 and 40 days, respectively, after surgery. They were the only late deaths, and actuarial survival rates were 87% (70% confidence level [CL], 83-89%) at 45 days and 87% (70% CL, 68-95%) at 52 months. Another patient had a myocardial infarction 50 days after surgery and is well 50 months later. Pulmonary stenosis was observed in 14 patients (10.3%) during the first year after surgery; two patients were reoperated on 10 and 12 months, respectively, after ASO. Aortic regurgitation was observed in 17 patients: two had grades II and III, respectively, aortic regurgitation on aortography; in 15 patients, it was detected only by Doppler examination. At the last follow-up (2-52 months after ASO; mean, 27.3 +/- 11.3 months), all patients were asymptomatic and taking no medication. On bidimensional echocardiography, left ventricular fractional shortening was normal at rest in all survivors but one. One patient had junctional rhythm, and one had Wenckebach periods; the remainder were in sinus rhythm. For as long as 5 years after ASO, late death and reintervention were rare; 99% of the survivors were asymptomatic and had sinus rhythm and good systemic ventricular function.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗

PubMed1990

Hypoplastic transverse arch and coarctation in neonates. Surgical reconstruction of the aortic arch: a study of sixty-six patients.

From Jan. 1, 1983, to Jan. 1, 1988, 66 consecutive neonates with coarctation and severe hypoplasia of the transverse arch underwent coarctation repair by resection of the coarctation and reconstruction of the aortic arch. Mean age at operation was 14 +/- 8 days, ranging from 2 to 30 days; 63% of the newborn infants were less than 2 weeks of age. The coarctation was isolated in 23%, associated with a ventricular septal defect in 39%, and associated with complex anomalies in 38%, including 16 cases of transposition of the great arteries or doublet-outlet right ventricle plus ventricular septal defect, two cases of simple transposition, two of corrected transposition plus ventricular septal defect, and five cases of "hypoplastic" left ventricle. The surgical technique comprises a wide resection of the coarctation extended to the contiguous ductal tissue followed by the reconstruction of the aortic arch in bringing the descending aorta into the concavity of the aortic arch. This technique is able to relieve the obstruction of the aortic arch provided that (1) the descending aorta is widely dissected to allow mobilization and (2) the incision of the transverse arch is extended proximal to the ostium of the left carotid artery. The operation was performed through a left thoracotomy in 62 patients and through a sternotomy in four additional neonates with transposition and ventricular septal defect who underwent a one-stage repair with aortic reconstruction, closure of the defect, and arterial switch. The overall early mortality rate (less than 30 days) was 14% (9/66; 95% confidence limits = 5% to 22%), including four deaths occurring within the first month, at a concomitant or subsequent repair of the associated anomaly. There were six late deaths, all related to the associated lesions. The overall mortality rate was 23% (15/66; 95% confidence limits = 13% to 33%). The mean follow-up was 21 +/- 10 months, ranging from 6 to 66 months. Actuarial survival rates at 5 years are 72% +/- 10% for the overall group; 87% +/- 17% for simple coarctation; 88% +/- 12% for coarctation and ventricular septal defect; and 52% +/- 18% for complex coarctation. The rate of recurrent coarctation was 12.5% (95% confidence limits = 2% to 23%), leading to five reoperations with no deaths. Freedom from reoperation was 89.5% +/- 9% at 5 years. This technique of coarctation repair offers several advantages: low operative mortality, complete relief of the left ventricular obstruction, wide resection of the ductus tissue, absence of prosthetic material, and preservation of the left subclavian artery.

Aorta, Thoracic↗

PubMed1989

[Repair of ventricular septal defects before 6 months of age. Apropos of a series of 194 infants].

Between 1982 and 1988, 194 infants under 6 months of age underwent surgical closure of a ventricular septal defect at the Marie Lannelongue Surgical Centre. The hospital death in this series was 6.7 p. 100. Mortality was influenced by the infant's age, by associated cardiac or extracardiac lesions and by the pre-operative ventilatory status. A residual ventricular septal defect was present in 11 infants (5.6 p. 100). Complete atrioventricular block occurred in 2 cases (1.1 p. 100). These results are in favour of a complete repair of simple ventricular septal defects at a very young age if medical treatment does not result in a satisfactory improvement.

Abnormalities, Multiple↗

PubMed1989

[Anatomical repair of transposition of the great vessels in the neonatal period. 5 years' experience. 246 patients].

In the period between april 1984 and march 1989, 246 newborn children with transposition of the great vessels benefited from anatomical repair of their heart disease. 221 children had simple transposition with normal interventricular septa. These were aged 2 to 23 days (mean age 7.8 +/- 3.5 standard deviation). 25 had transposition of the great vessels associated with a large interventricular septum defect. These were aged 7 to 30 days (mean age 18 +/- 8.3 S.D.). Associated lesions included a small interventricular septum defect in 20 cases which was not treated at the time of the operation; tricuspid insufficiency in 3 cases; and isthmic coarctation of the aorta in 10 cases. According to Yacoub's classification relative to the anatomical distribution of the coronary arteries, all the children fell into the following groups: type A, 172 cases; type B, 8 cases; type C, 12 cases; type D, 40 cases; type E, 14 cases. Preoperative catheterization was carried out in all the children. 96% benefited from Rashkin's atrioseptostomy, 90% had a prostaglandin infusion continuing through surgery. The surgical technique included the use of continuous extracorporal circulation at 20 degrees C, without circulatory arrest. Protection of the myocardium was ensured during aortic clamping by injecting of a crystalloid cardioplegia-inducing solution. The main steps of surgical repair were repositioning of the coronary arteries onto the ancient aortic stump and reconstruction of a pulmonary shunt. Repositioning of the coronary arteries was carried out in accordance with Yacoub's technique in all cases except for the 10 first patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMed1988

[Congenital tracheal stenosis due to complete circular rings. Tracheoplasty using autologous pericardium].

The case of a 9-month old infant with congenital tracheal stenosis due to complete tracheal rings, associated with an aberrant left pulmonary artery is reported. Surgery was carried out under extracorporeal circulation to ensure adequate oxygen supply. Extubation, thus made possible, enabled the lesion to located accurately by bronchoscopy. Tracheoplasty by means of an autologus pericardial patch was performed. The quality of the repair was checked by a second bronchoscopy. The long-term result is satisfactory.

Cartilage↗

PubMed1988

[Complete repair of the interrupted aortic arch by an anterior approach. Apropos of 9 cases].

Interrupted aortic arch is a duct-dependent heart disease, and this is why the use of prostaglandins E, which keep the ductus arteriosus open to feed the descending aorta, has transformed its formerly sombre prognosis. The authors report the cases of 9 neonates and infants presenting with interrupted aortic arch associated with ventricular septal defect who underwent total repair of the malformations under extracorporeal circulation. Five children were less than 10 years' old. The aortic lesions were of type A in 2 cases (interruption distal to the left subclavian artery) and of type B in 7 cases (interruption between the left carotid and subclavian arteries). In the second group the lesions were of type B1 in 5 cases (without retro-oesophageal right subclavian artery) and of type B2 in 2 cases (right retro-oesophageal artery distal to the interruption). There was one death (11 p. 100). So far, no child has been reoperated upon for residual aortic obstruction or reopened ventricular septal defect. This technique of total repair in one stage, with closure of the ventricular septal defect, seems to be preferable to the two-stage technique in which stage one includes, in addition to aortic arch repair, cerclage of the pulmonary artery, a procedure with numerous disadvantages and a higher overall mortality rate.

Aortic Arch Syndromes↗

PubMed1988

Switch operation for transposition of the great arteries in neonates. A study of 120 patients.

From March 1984 to January 1987, anatomic surgical correction was performed on 110 newborn infants (2 to 23 days old, mean 7.8 +/- 3.5, standard deviation) with simple transposition of the great arteries and 10 additional neonates (7 to 30 days old, mean 17.9 +/- 8.3, standard deviation) with transposition and a large ventricular septal defect. All had preoperative catheterization. Ninety-six percent of the patients underwent balloon atrial septostomy and 90% received prostaglandin E1 infusion until the time of the operation. The anatomy of the coronary arteries according to the Yacoub classification was as follows: type A, 82 patients; type B, 5 patients; type C, 4 patients; type D, 23 patients; and type E, 6 patients. Continuous hypothermic bypass with no circulatory arrest was used for all patients except two. Myocardial protection was ensured by crystalloid cardioplegia. Coronary artery relocation was performed according to the Yacoub technique with some modifications, and pulmonary artery reconstruction was done according to the Lecompte maneuver in all patients, even when the great vessels had a side-by-side relationship. The proximal pulmonary artery was reconstructed with two circular patches for the first 10 patients and with a single large posterior patch for the last 110 patients. Tanned heterologous pericardium was used for the first 25 patients and autologous native pericardium for the last 95 patients. The perioperative mortality rates were 8.3% for the entire series and 5.4% for the last 110 patients, with no deaths in the group having transposition plus ventricular septal defect. Late death from acute myocardial infarction occurred in two patients in the second month after operation. No patient was lost to follow-up, which ranged from 2 to 46 months (mean 16 +/- 11.2, standard deviation). The follow-up included sequential noninvasive evaluations and 32 catheterizations performed 10 to 18 months postoperatively. Two patients were reoperated on for pulmonary stenosis caused by retraction of the two heterologous pericardial patches, but neither died. Six others have mild to moderate pulmonary stenosis. Two patients have trivial aortic regurgitation. None have aortic dilatation or supravalvular aortic stenosis. The 108 survivors have no cardiovascular symptoms. They all are in sinus rhythm, have normal left ventricular function, have no ischemic problems, and receive no medication.

Coronary Vessels↗

PubMed1987

Anatomic correction of simple transposition of the great arteries in 50 neonates.

From April 1984 to January 1986, anatomic surgical correction was performed in 50 newborn (2- to 23-day-old, mean 8 +/- 5 [SD]) infants with simple transposition of the great arteries. Before surgery, balloon atrial septostomy was performed in all patients, prostaglandin E1 was infused in 42, and left ventricular shape on a two-dimensional echocardiogram was considered "satisfactory" in 48. Surgery was performed in patients on cardiopulmonary bypass without cardiac arrest; the pulmonary artery was reconstructed by end-to-end anastomosis according to Lecompte's maneuver with a pericardial patch. In all but one patient coronary artery transfer was possible regardless of the distribution of these vessels. There were eight early deaths (16%), but only four (10%) of the last 41 patients treated died. There was one late death (2%) due to a secondary myocardial infarction caused by compression of the left coronary artery. Reoperation was successfully performed in two patients for supravalvar pulmonary artery stenosis. The only late medical complication was a transient episode of myocardial ischemia 6 months after surgery. The 41 late survivors were in excellent condition, were in sinus rhythm, and had a normal left ventricle 1 to 22 months after surgery (mean 7.2 +/- 5.4 [SD]). Aortic growth was normal; pulmonary artery supravalvar stenosis occurred in six patients (mild in four). We conclude that anatomic correction can be applied successfully in the first few days of life in newborns with simple transposition of the great arteries, regardless of coronary distribution.

Cardiopulmonary Bypass↗