The surgical management of pulmonary atresia with ventricular septal defect (VSD) and hypoplastic pulmonary arteries poses difficult problems. Adequate palliation was achieved in two such patients by restoring continuity between the right ventricle and the pulmonary arteries by means of a woven Dacron patch. The VSD was left unrepaired. Angiography performed one month after operation showed the reconstructed pulmonary outflow tract to be widely patent and the pulmonary arteries to be enlarged. This approach may allow subsequent total correction by closure of the VSD in these hopeless patients.
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