Long-time observations on the Blalock-Taussig operation IX. Single ventricle (with apex to the left)

This report concerns a 20 to 28 year follow-up of patients with a single ventricle with pulmonary stenosis and levocardia, a malformation which is frequently combined with a transposition of the great vessels. Only 24 cases were found among the 1037 cyanotic patients with decreased pulmonary blood flow operated on between January 1, 1945 and January 1, 1951. Of the 18 patients who survived surgery, one has been lost to follow-up, eight have lived for more than 20 years, and six for more than 25 years after their initial operation. The results of a Blalock-Taussig operation for a single ventricle are less satisfactory than for a tetralogy of Fallot. Two patients who were living at the close of the study have had no further surgery. Seven patients have had a second operation and four patients have had a third. Progressive cardiac enlargement has been common. The period of enlargement has varied from 10 months to more than 20 years. Three patients have had subacute bacterial endocarditis; two had multiple attacks. One patient died of a brain abscess and one of a purulent meningitis. Three women and four men have married. All four men have A.B. degrees and are gainfully employed.