Additional aortopulmonary anastomosis for subaortic obstruction in the Rastelli-type repair for the Taussig-Bing malformation.

In the Taussig-Bing malformation, residual subaortic obstruction from a hypertrophied subaortic conus is often a problem at the time of intraventricular repair. To alleviate this problem, during a Rastelli-type repair involving an extracardiac valved conduit and an intraventricular connection from the ventricular septal defect to both aortic and pulmonary outflows, an additional side-to-side anastomosis between the ascending aorta and the proximal portion of the divided pulmonary artery can be performed, creating a supplementary outflow for the left ventricle. This method was used in 2 patients who had anteroposterior transposition of the great arteries, with 1 long-term survivor.