Transatrial-transpulmonary repair of XXXX .

@entity1 @entity154 @entity215 @entity1757 @entity849 @entity358
Classical @entity215 was repaired by a transatrial-transpulmonary approach in 61 of 70 @entity1 treated surgically on one surgical service between July 1981 and December 1985. Their ages ranged from 2.5 months to 57 years (mean 52.9 +/- 104.2 months). The @entity1757 was closed through the right atrium and tricuspid valve in 60 @entity1 and via the pulmonary artery in one @entity1 with a @entity154 . @entity358 was made in 38 @entity1 to expose the stenotic pulmonary valve for valvotomy and to begin the infundibular mobilization and resection. It was extended through a small pulmonary anulus primarily in 15 @entity1 and secondarily in one, a minimal distance upon the right ventricular infundibulum to enlarge the outflow tract to 2 standard deviations larger than the mean normal pulmonary valve anulus diameter. There were no hospital or late deaths or reoperations among the entire group. The mean postrepair peak right ventricular/left ventricular pressure measured in the operating room was 0.52 +/- 0.165 for the entire group of 61 @entity1 which indicates similar relief of @entity849 to that obtained by the classical transventricular repair. At follow-up between 2.3 and 53.8 months (mean 22.6) each @entity1 was in New York Heart Association Class I and without cardiac medication. Postoperative cardiac catheterization studies performed in nine @entity1 between 4 and 28 months after operation showed no residual @entity1757 and a mean peak right/left ventricular pressure of 0.42 +/- 0.13. This series indicates that successful repair of @entity215 can be accomplished in most @entity1 by a transatrial-transpulmonary approach, which may provide improved right ventricular function over the long term.
