The surgical anatomy of the Taussig-Bing malformation

There is no consensus as to the most appropriate definition of the use of the term Taussig-Bing malformation. In this study, we endorse the suggestion that the lesion be considered a spectrum of anomalies, unified by a juxtapulmonary ventricular septal defect with malalignment of the infundibular septum. The ends of the spectrum are hearts with, on the one hand, double-outlet right ventricle and, on the other hand, a discordant ventriculoarterial connection. We studied 10 hearts within this spectrum, eight with a double outlet and two with discordant ventriculoarterial connection. We found that the same basic morphology could exist with a bilaterally complete infundibulum or in the presence of fibrous continuity between the mitral and the pulmonary valves. Features of most significance for surgical correction were the arrangement of the outlet septum (particularly the presence or absence of chordal attachments from the atrioventricular valves), the morphology of the coronary arteries, and the state of the subaortic infundibulum. The options for surgical correction are determined by the internal morphology of the lesions rather than by the precise ventriculoarterial connection.