ANATOMIC CORRECTION OF ATRIOVENTRICULAR DISCORDANCE

Between June 1989 and September 1991, 11 patients underwent anatomic c orrection of atrioventricular discordance. Their ages at operation ran ged from 1 to 11 years (mean 6.7 years) and their weights ranged from 7.1 to 31.8 kg (mean 19.1 kg). Atrial situs was solitus in nine and in versus in two patients. Ventriculoarterial connection was discordant i n five and was double-outlet right ventricle in six patients. Associat ed congenital heart defects were seen in all patients, including 10 wi th ventricular septal defect, eight with atrial septal defect, nine wi th pulmonary stenosis or pulmonary atresia, seven with tricuspid regur gitation, and four with mitral regurgitation. Five patients had prior Blalock-Taussig shunts. One patient with an intact ventricular septum had repeated pulmonary banding. Anatomic correction consisted of the S enning and Rastelli procedures in three, the Mustard and Rastelli proc edures in five, the Senning and arterial switch operations in two, and the Mustard and arterial switch operations in one patient. In additio n, mitral valvuloplasty or valvular annuloplasty was performed in thre e patients. We did not encounter kinking or torsion of the translocate d coronary arteries in our three patients with the arterial switch ope ration. There was one surgical death. The other patients pursued satis factory postoperative courses (mean follow-up period of 12.6 months). We recommend that anatomic correction for atrioventricular discordance should be indicated, especially in patients with any sign of systemic right ventricular dysfunction.