Physiological approach to surgery for XXXX .

@entity1 @entity1145 @entity1757 @entity509 @entity551 @entity204
A modification of Fontan's approach to the surgical management of @entity1145 was employed in nine @entity1 . A valved conduit was used to create continuity between the right atrium and the surgically modified right ventricular chamber. Six @entity1 had had previous shunting procedures. Preoperative studies revealed various degrees of @entity509 of the right ventricle beneath relatively normal pulmonary valves. At surgery, the atrial septal and @entity1757 were closed, the right ventricular chamber was enlarged, and right atrial-right ventricular continuity was established with a valved conduit. There was one @entity204 . The eight survivors have been clinically well as long as 3 1/2 years following surgery. Postoperative cardiac catheterization was performed in five @entity1 . Ventricularized pressure tracings were recorded in the right ventricular chambers and the morphology of the @entity551 curves were normal. In all instances, angiography demonstrated significant enlargement of a pulsatile right ventricular chamber. Thus, in many @entity1 with @entity1145 , establishment of a four-chambered, four-valved heart is feasible, both from an anatomic and physiologic standpoint.
