Aorta to Right Pulmonary Artery Anastomosis (Waterston's Operation) for Cyanotic Heart Disease

Thirty patients with cyanotic heart disease, including Fallot's tetralogy, transposition of the great arteries, and tricuspid atresia had Waterston's anastomosis for gross effort intolerance or cyanotic attacks. The results were good in 28. Spontaneous closure of the anastomosis occurred in one patient. There was a tendency for preferential perfusion of the right lung, and unilateral pulmonary edema occurred in nine patients. Congestive heart failure appeared when the stoma was too large. Surgical technic to avoid kinking of the right pulmonary artery has been modified, and the importance of limiting the size of the anastomosis has been emphasized. Transaortic closure of the anastomosis through the aorta at the time of definitive correction was simple in three patients.