Intraventricular repair for Taussig-Bing anomaly.

Among 41 patients with Taussig-Bing anomaly who underwent intracardiac repair, 10 patients were treated by intraventricular rerouting repair. The ages at operation ranged form 1 month to 8 years (average 2 years 3 months). Primary repair was done in four (average age 2 years 7 months), and repair was done after pulmonary artery banding in six patients (average age 2 years 2 months). The relationship of the great arteries was side by side in nine patients and oblique in one. After extensive resection of the infundibular septum, a distance of 8 to 18 mm from the tricuspid ring or chordae to the pulmonary valve was obtained (24% to 71% of total circumference for the subaortic route). The subaortic route was created to obtain an internal diameter at least equal to that of the aortic route. Tricuspid chordal or papillary muscle reattachment was performed in two patients. There were no early or late deaths. Follow-up ranged from 1 year 4 months to 22 years 3 months (average 5 years 8 months), and reoperation was required in one patient for residual pulmonary stenosis. The intraoperative pressure gradient between the left ventricle and aorta was 0 to 24 mm Hg (average 10.3 mm Hg), and postoperative study showed the gradients to be less than 19 mm Hg (n = 8). The age at operation, left ventricular-aortic pressure gradient, and postoperative tricuspid regurgitation were not significantly affected by the presence of severe hypertrophy of the infundibular septum (n = 4). These results indicate that intraventricular rerouting may be feasible in most patients who have the Taussig-Bing anomaly with side-by-side or similar relationships of the great arteries, and the age and conal anatomic variations do not appear to be significant limiting factors.