A New Technic for Complete Correction of Transposition of the Great Vessels An Experimental Study with a Preliminary Clinical Report

great vessels is a common congenital cardiovascular anomaly. In this disease the aorta with its coronary arteries originates from the right ventricle, and the pulmonary artery arises from the left ventricle. Conse-quently, the aorta carries venous blood; the pulmonary artery, oxygenated blood. Surgical correction of this malformation has been beset with many difficulties and re-mains a challenge to the cardiac surgeon. Many technics have been devised for its com-plete or partial correction.12 A logical method for correcting this anomaly is retrans-posing the aorta and pulmonary artery. A major technical difficulty in this approach has been transfer of the coronary arteries. Obviously, if they are left in place after trans-planting the major vessels, the myocardium will continue to be supplied with venous blood. Experimental Work From a study of autopsy heart specimens with transposition of the great vessels, the following observations were made: The right and left coro-nary arteries arise from the posterior sinuses of the aorta (fig. 1, nos. 3 and 4), approximately 5 to 7 mm. above the bottom of the aortic sinuses. The proximal portion of the coronary artery seg-ments is not embedded in the myocardium as is usual in the normal heart. At their origin the coronary arteries are separated from the mnyo-cardium by a small triangular space filled with fat and areolar tissue, which facilitates their dis-section. These observations led us to develop a techni