The first open-heart repairs of XXXX , atrioventricular communis, and tetralogy of Fallot using extracorporeal circulation by cross-circulation: a 30-year follow-up.

@entity1 @entity473 @entity339 @entity120 @entity1757 @entity299 @entity1146 @entity616
From March 26, 1954, to July 19, 1955, 45 @entity1 with major @entity299 not previously correctable underwent open repair utilizing cross-circulation between @entity1 and donor without donor deaths. All operations were carried out at normothermia with lowered flow rates based on azygos flow studies. Twenty-seven @entity1 , more than half of them @entity1 , had @entity1757 closed. There were 8 hospital deaths, and there have been only 2 late deaths in 30 years. Fourteen (87.5%) of 16 who underwent recatheterization have closed defects. The 17 30-year-survivors are all in New York Heart Association Functional Class I. Five @entity1 4 months to 10 years old were operated on for @entity473 (complete form). All had intractable failure, and 4 had @entity120 . Two of the 3 hospital deaths were due to @entity616 . The long-term survivor, a 15-month-old @entity1 at the time of operation (severe @entity120 , 90/50 mm Hg), underwent repair 31 years ago and is now married with 3 @entity1 . Recatheterization disclosed normal pulmonary pressure (20/4 mm Hg), no shunts, and mild @entity339 . Ten cyanotic tetrads 13 months to 14 years old were operated on with 5 hospital deaths. Of the 3 late deaths, 1 was accidental at 17 years, 1 occurred suddenly at home 13 years after operation in infancy for @entity1146 , and the third occurred at reoperation 10 years later. The 2 remaining @entity1 (1 the first @entity1 operated on) are in excellent health. The surgical methods used and the physiological advantages of cross-circulation (temporary placenta) that made these results possible at a time when surgical knowledge was primitive are described.
