[A case of modified Fontan operation for corrected transposition of great arteries (I.D.D.) with atrial septal defect, ventricular septal defect, pulmonary stenosis, mitral atresia and hypoplastic left ventricle].

A 14-year-old boy with corrected transposition of the great arteries (I.D.D.), atrial septal defect, ventricular septal defect, pulmonary stenosis, mitral atresia and hypoplastic left ventricle was successfully operated. He had undergone modified Blalock-Taussig shunt at the age of two. After atrial septal defect was closed with bovine pericardial patch, small ventricular septal defects were closed directly through left ventricular incision. Then the incisional line on the left ventricle was extended to pulmonary artery. The stenotic and thickened pulmonary valve was excised. The upper part of the incisional line on the right atrium and that on the left ventricle were anastomosed. Consequently the connection between the right atrium and the pulmonary artery was able to be made through hypoplastic left ventricle. This case is extremely rare type in terms of mitral atresia and is classified as Group II, type B according to Eliot's classification. This type of repair is similar to Björk's method, however, we could not make use of left ventricular contraction because it was weak. The merit of this procedure was to be able to reconstruct blood tract without using artificial conduits.