Taussig-Bing Malformation, Coarctation of the Aorta, and Reversed Patent Ductus Arteriosus

Abstract

SUMMARYboth great vessels from the right ventricle, and to discuss methods of operative correction. Report of CaseThis male infant was the product of a full-term pregnancy, uncomplicated by infections or drugs. He weighed 3.4 kg at birth. Cyanosis occurred shortly after birth, and a systolic heart murmur was heard at 2 weeks of age. At age 4 mo congestive heart failure was recognized, and he responded to digitalis.At age 13 mo (January 1968), when he was referred to the University of Minnesota Medical Center, the mother reported increasing cyanosis, mild tachypnea, and delayed growth and devel-

Taussig-Bing anomaly and coarctation of the aorta in infancy: Surgical options

“…The anatomic classification of DORY is based upon the location of a VSD relative to the great vessels : subaortic, subpulmonary, doubly committed, and noncommitted [15) . The subpulmonic location of the large VSD in the T-B anomaly causes cyanosis due to preferential streaming of blood from the left ventricle into the pulmonary artery and from the right ventricle into the aorta [20,43] . The absence of pulmonary stenosis results in increased pulmonary blood flow, pulmonary hypertension, and congestive heart failure .…”

“…The increased afterload imposed by CoA exacerbates the already excessive pulmonary flow . The high pulmonary blood flow at systemic levels causes severe pulmonary vascular obstructive disease to develop at an early age [43] . The presence of reversed differential cyanosis of the upper and lower extremities in three of our patients is a clue to the diagnosis due to right-to-left shunting of oxygenated blood through a large PDA with a juxtaductal CoA [43] .…”

“…Coarctation of the aorta is commonly associated with T-B anomaly 119, 22,26,27,35,43,46], but the prognosis with their coexistence is considerably worse than with T-B alone [35] . Of 55 cases of T-B without pulmonary stenosis, 35 (53%) have been reported as successful repairs [1, 5, 8-11, 13, 14, 23, 24, 29-31, 34, 36, 37, 44, 45] .…”

“…Of 55 cases of T-B without pulmonary stenosis, 35 (53%) have been reported as successful repairs [1, 5, 8-11, 13, 14, 23, 24, 29-31, 34, 36, 37, 44, 45] . To our knowledge, there have been 22 reported cases of T-B and CoA treated surgically [3,8,27,28,33,35,43] (Tables I and 2) . There have been 15 neonates (< I month of age) undergoing CoA repair with or without PAB .…”

From Crafoord’s End-to-End Anastomosis Approach to Percutaneous Interventions: Coarctation of the Aorta Management Strategies and Reinterventions

“…Subsequently, the remaining aortic arch just distal to the left subclavian artery and descending aorta were connected with a direct end-to-end anastomosis. However, this initial repair was associated with a relatively high incidence of recoarctation, with reported rates ranging from 41% to 51% [10][11][12][13]. Recoarctation was found to be age-dependent and most pronounced when the surgery was performed in neonates.…”