Anatomic correction of the Taussig-Bing anomaly

Anatomic correction of the Taussig-Bing anomaly depends on thorough understanding of the variable interrelations between the atrioventricular valves, ventricular septal defect, infundibular muscle bands, and aortic and pulmonary outflows and the resulting haemodynamic changes. Depending on the relative position of the great arteries, two clinicopathological types have been identified. In the two patients with side-by-side relationship of the great arteries, the conal septum was well developed, so that there were various degrees of subaortic stenosis. Associated coarctation of the aorta was present in both patients. Coronary anatomy was identical (Type E) to that present in complete transposition with side-by-side great arteries. In these patients, anatomic correction was achieved by wide excision of the conal septum and intraventricular repair. In contrast, two patients with anteroposterior relationship of the great arteries had a poorly developed conal septum and no subaortic stenosis or coarctation of the aorta. In these patients, repair was achieved by diverting blood from the ventricular septal defect to the adjoining pulmonary artery combined with switching of the great arteries and coronary transfer. There were no early or late deaths associated with either method of repair, and there was evidence of good correction of the hemodynamic abnormalities. It is concluded that anatomic correction is possible in all patients with the Taussig-Bing anomaly and that the method of repair depends on the relative position of the great arteries.