Circulatory Bypass of the Right Side of the Heart

IT HAS been more than 10 years since our first successful anastomosis of the side of the superior vena cava to the distal end of the right pulmonary artery in a dog.' The dog is still alive, in fact is robust and leading an active life in a domestic environment. In the 10 years following, several hundred experimental anastomoses have been performed. Results of these have been reported recently.2 From this experimental work it has become evident that partial bypass with the superior vena cava is preferable to that with the inferior vena cava. Total right heart bypass has never resulted in prolonged survival in animals and probably is not practical in man. More than 6 years have elapsed since our first successful superior vena cava-pulmonary artery anastomosis in a patient.3 Since operation, the patient, a 7-year-old boy with transposition of the great vessels and pulmonary stenosis, has been free from complaints, except for a mild cyanosis increasing on vigorous exercise, and has been leading a normal life. The cava-pulmonary artery anastomosis has been used in 3S patients in our clinic. All patients had severe malformation of the right side of the heart for which no established corrective procedure was available. It is the purpose of this present paper to report the postoperative results and show our progress with the clinical application of the procedure, not to offer a definitive evaluation that must