Intraventricular tunnel repair for Taussig-Bing heart and related cardiac anomalies.

Uncertainty currently exists as to the optimal definitive procedure for treatment of patients with the Taussig-Bing heart and related cardiac anomalies. Between December 1, 1981 and October 1, 1985, we have used a completely intraventricular tunnel repair, without the use of an extracardiac conduit, in nine patients between 1 and 33 months of age. There was one hospital death from low cardiac output in a 1-month-old infant and one late death 11 months after repair from preexisting and progressive right ventricular cardiomyopathy. Six patients had the Taussig-Bing heart and three had transposition of the great arteries with a ventricular septal defect (VSD). The specific type of tunnel used was determined by the intracardiac anatomy and VSD enlargement was necessary in six patients. Three reoperations were required, two for recurrent VSD between 1 and 3 months after repair and one for tricuspid valve replacement in the patient with right ventricular cardiomyopathy 6 months later. The remaining seven patients are in NYHA class I 1.3 to 47 months postoperatively. We conclude that continued and perhaps expanded use of this technique is appropriate.